Basic Information
| Provider Information | |||||||||
| NPI: | 1407117930 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | MEREDITH | ||||||||
| FirstName: | JANET | ||||||||
| MiddleName: | MARKWORDT | ||||||||
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| Credential: | RPH-BS PHARMACY | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 2765 | ||||||||
| Address2: | |||||||||
| City: | DEL MAR | ||||||||
| State: | CA | ||||||||
| PostalCode: | 92014 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8585528585 | ||||||||
| FaxNumber: | 8585527522 | ||||||||
| Practice Location | |||||||||
| Address1: | 3350 LA JOLLA VILLAGE DR | ||||||||
| Address2: | VA MEDICAL CENTER - PHARMACY DEPT - 119 | ||||||||
| City: | SAN DIEGO | ||||||||
| State: | CA | ||||||||
| PostalCode: | 92161 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8585528585 | ||||||||
| FaxNumber: | 8585527522 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/31/2012 | ||||||||
| LastUpdateDate: | 05/31/2012 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 183500000X | 45997 | CA | Y | Pharmacy Service Providers | Pharmacist |
No ID Information.