Provider Demographics
NPI:1033521539
Name:MEANY, KIMBERLY ELIZABETH (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:KIMBERLY
Middle Name:ELIZABETH
Last Name:MEANY
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8491 FORT SMALLWOOD RD
Mailing Address - Street 2:
Mailing Address - City:PASADENA
Mailing Address - State:MD
Mailing Address - Zip Code:21122-2739
Mailing Address - Country:US
Mailing Address - Phone:410-255-5364
Mailing Address - Fax:
Practice Address - Street 1:8491 FORT SMALLWOOD RD
Practice Address - Street 2:
Practice Address - City:PASADENA
Practice Address - State:MD
Practice Address - Zip Code:21122-2739
Practice Address - Country:US
Practice Address - Phone:410-255-5364
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-06-02
Last Update Date:2014-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD20758183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist