Provider Demographics
NPI:1295375236
Name:WELTY, MEREDITH (PHARMD)
Entity Type:Individual
Prefix:
First Name:MEREDITH
Middle Name:
Last Name:WELTY
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 1:103 TALL OAKS DR APT 2G
Mailing Address - Street 2:
Mailing Address - City:GREENSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27455-3026
Mailing Address - Country:US
Mailing Address - Phone:336-971-8756
Mailing Address - Fax:
Practice Address - Street 1:3330 W FRIENDLY AVE
Practice Address - Street 2:
Practice Address - City:GREENSBORO
Practice Address - State:NC
Practice Address - Zip Code:27410-4806
Practice Address - Country:US
Practice Address - Phone:336-297-1361
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-01-07
Last Update Date:2020-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL20611183500000X
NC28299183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist