Provider Demographics
NPI:1679851810
Name:MOY, MEREDITH (PHARMD)
Entity Type:Individual
Prefix:
First Name:MEREDITH
Middle Name:
Last Name:MOY
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 1:3201 TIOGA PKWY
Mailing Address - Street 2:T-2393
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21215-7987
Mailing Address - Country:US
Mailing Address - Phone:410-369-1007
Mailing Address - Fax:
Practice Address - Street 1:3201 TIOGA PKWY
Practice Address - Street 2:T-2393
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21215-7987
Practice Address - Country:US
Practice Address - Phone:410-369-1007
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-07-21
Last Update Date:2011-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD20237183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist