Provider Demographics
NPI:1417593369
Name:BRINKER, MEAGAN JEAN (PHARMD)
Entity Type:Individual
Prefix:
First Name:MEAGAN
Middle Name:JEAN
Last Name:BRINKER
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 1:6158 HIGGINS AVE
Mailing Address - Street 2:
Mailing Address - City:STERLING HEIGHTS
Mailing Address - State:MI
Mailing Address - Zip Code:48314-1433
Mailing Address - Country:US
Mailing Address - Phone:810-444-9997
Mailing Address - Fax:
Practice Address - Street 1:2058 25 MILE RD
Practice Address - Street 2:
Practice Address - City:SHELBY TOWNSHIP
Practice Address - State:MI
Practice Address - Zip Code:48316-1096
Practice Address - Country:US
Practice Address - Phone:248-651-9752
Practice Address - Fax:348-651-1678
Is Sole Proprietor?:Yes
Enumeration Date:2019-11-25
Last Update Date:2019-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5302038356183500000X, 1835P0018X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P0018XPharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
No183500000XPharmacy Service ProvidersPharmacist