Provider Demographics
NPI:1225440605
Name:MEYER, THERESA O'REILLY (RPH)
Entity Type:Individual
Prefix:
First Name:THERESA
Middle Name:O'REILLY
Last Name:MEYER
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5204 JACKSON RD STE C
Mailing Address - Street 2:
Mailing Address - City:ANN ARBOR
Mailing Address - State:MI
Mailing Address - Zip Code:48103-1866
Mailing Address - Country:US
Mailing Address - Phone:734-821-8000
Mailing Address - Fax:734-821-8001
Practice Address - Street 1:5204 JACKSON RD STE C
Practice Address - Street 2:
Practice Address - City:ANN ARBOR
Practice Address - State:MI
Practice Address - Zip Code:48103-1866
Practice Address - Country:US
Practice Address - Phone:734-821-8000
Practice Address - Fax:734-821-8001
Is Sole Proprietor?:No
Enumeration Date:2014-05-20
Last Update Date:2023-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5302032356183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist