Provider Demographics
NPI:1760931976
Name:MEADOWS, KURT (PHARMD)
Entity Type:Individual
Prefix:
First Name:KURT
Middle Name:
Last Name:MEADOWS
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:106 BROOKWOOD LN
Mailing Address - Street 2:
Mailing Address - City:BECKLEY
Mailing Address - State:WV
Mailing Address - Zip Code:25801-2304
Mailing Address - Country:US
Mailing Address - Phone:304-253-9429
Mailing Address - Fax:
Practice Address - Street 1:133 BECKLEY CROSSING SHPG CTR
Practice Address - Street 2:
Practice Address - City:BECKLEY
Practice Address - State:WV
Practice Address - Zip Code:25801-7100
Practice Address - Country:US
Practice Address - Phone:304-252-3480
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-09-28
Last Update Date:2016-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WVRP0009887183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist