Provider Demographics
NPI:1114284866
Name:CAVAZOS, MEGHAN E (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:MEGHAN
Middle Name:E
Last Name:CAVAZOS
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:DR
Other - First Name:MEGHAN
Other - Middle Name:E
Other - Last Name:GEHRETT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PHARMD
Mailing Address - Street 1:3095 N MONTANA AVE
Mailing Address - Street 2:
Mailing Address - City:HELENA
Mailing Address - State:MT
Mailing Address - Zip Code:59601-0552
Mailing Address - Country:US
Mailing Address - Phone:406-443-3331
Mailing Address - Fax:
Practice Address - Street 1:3095 N MONTANA AVE
Practice Address - Street 2:
Practice Address - City:HELENA
Practice Address - State:MT
Practice Address - Zip Code:59601-0552
Practice Address - Country:US
Practice Address - Phone:406-443-3331
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-04-19
Last Update Date:2013-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPH60162002183500000X
WI1607840183500000X
MT15067183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist