Provider Demographics
NPI:1730638685
Name:SUPPLE, MEGAN E (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:MEGAN
Middle Name:E
Last Name:SUPPLE
Suffix:
Gender:F
Credentials:PHARMD
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Mailing Address - Street 1:3214 BRASSFIELD RD
Mailing Address - Street 2:APT 1207
Mailing Address - City:GREENSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27410-9619
Mailing Address - Country:US
Mailing Address - Phone:585-698-9198
Mailing Address - Fax:336-938-0757
Practice Address - Street 1:1126 N CHURCH ST
Practice Address - Street 2:STE 300
Practice Address - City:GREENSBORO
Practice Address - State:NC
Practice Address - Zip Code:27401-1000
Practice Address - Country:US
Practice Address - Phone:336-938-0714
Practice Address - Fax:336-938-0757
Is Sole Proprietor?:No
Enumeration Date:2016-10-03
Last Update Date:2016-10-03
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NC251991835P2201X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P2201XPharmacy Service ProvidersPharmacistAmbulatory Care