Donna R Merideth, R.PH.

Individual provider Active NPI Pharmacist · Alpha, IL

NPI 1023604758 · NPPES record last updated Dec 16, 2020

Key facts

NPI
1023604758
Entity type
Individual (NPI type 1)
Primary specialty
Pharmacist 183500000X
License
051039108 (IL)
Practice address
211 S 1St St
Alpha, IL 61413-5152
Phone
(309) 629-4506
Fax
(309) 629-2611
NPI assigned
Dec 16, 2020
Sex
Female
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No
Credentials
Registered Pharmacist

State licenses

LicenseStateTypeSpecialty
051039108ILMDPharmacist

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 051039108 IL Yes

Addresses

Primary practice location

211 S 1St St
Alpha, IL 61413-5152

Mailing address

PO Box 355
Alpha, IL 61413-0355
Phone (309) 629-4506

Other practice location 1

855 Illini Dr Ste 200
Silvis, IL 61282-2908
Phone (309) 792-7002

Other providers in Alpha, IL

All providers in Alpha, IL · Pharmacist in Illinois

Sources for this page

Verify at the official NPI Registry.