Provider Demographics
NPI:1407117930
Name:MEREDITH, JANET MARKWORDT (RPH-BS PHARMACY)
Entity Type:Individual
Prefix:
First Name:JANET
Middle Name:MARKWORDT
Last Name:MEREDITH
Suffix:
Gender:F
Credentials:RPH-BS PHARMACY
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 2765
Mailing Address - Street 2:
Mailing Address - City:DEL MAR
Mailing Address - State:CA
Mailing Address - Zip Code:92014
Mailing Address - Country:US
Mailing Address - Phone:858-552-8585
Mailing Address - Fax:858-552-7522
Practice Address - Street 1:3350 LA JOLLA VILLAGE DR
Practice Address - Street 2:VA MEDICAL CENTER - PHARMACY DEPT - 119
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92161
Practice Address - Country:US
Practice Address - Phone:858-552-8585
Practice Address - Fax:858-552-7522
Is Sole Proprietor?:No
Enumeration Date:2012-05-31
Last Update Date:2012-05-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA45997183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist