Provider Demographics
NPI:1356014344
Name:PATRICH, MEGAN MARIE (PHARMD)
Entity Type:Individual
Prefix:
First Name:MEGAN
Middle Name:MARIE
Last Name:PATRICH
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:MEGAN
Other - Middle Name:MARIE
Other - Last Name:WESTERN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2385 NASHVILLE RD
Mailing Address - Street 2:
Mailing Address - City:BOWLING GREEN
Mailing Address - State:KY
Mailing Address - Zip Code:42101-4144
Mailing Address - Country:US
Mailing Address - Phone:270-393-8979
Mailing Address - Fax:
Practice Address - Street 1:2385 NASHVILLE RD
Practice Address - Street 2:
Practice Address - City:BOWLING GREEN
Practice Address - State:KY
Practice Address - Zip Code:42101-4144
Practice Address - Country:US
Practice Address - Phone:270-393-8979
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-07-27
Last Update Date:2021-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY022184183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist