Provider Demographics
NPI:1114396454
Name:JUNKER, MEREDITH (PHARMD)
Entity Type:Individual
Prefix:
First Name:MEREDITH
Middle Name:
Last Name:JUNKER
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 1:47243 175TH ST
Mailing Address - Street 2:
Mailing Address - City:CLEAR LAKE
Mailing Address - State:SD
Mailing Address - Zip Code:57226-5128
Mailing Address - Country:US
Mailing Address - Phone:605-874-3041
Mailing Address - Fax:
Practice Address - Street 1:109 S MAIN ST
Practice Address - Street 2:
Practice Address - City:MILBANK
Practice Address - State:SD
Practice Address - Zip Code:57252-1806
Practice Address - Country:US
Practice Address - Phone:605-432-5542
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-09-16
Last Update Date:2015-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SDR5304183500000X
MN117466183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist