Provider Demographics
NPI:1790030484
Name:GILL, MEGAN MARIE (RPH)
Entity Type:Individual
Prefix:MS
First Name:MEGAN
Middle Name:MARIE
Last Name:GILL
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8030 GERMANTOWN AVE
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19118-3421
Mailing Address - Country:US
Mailing Address - Phone:215-247-1221
Mailing Address - Fax:215-247-1179
Practice Address - Street 1:8030 GERMANTOWN AVE
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19118-3421
Practice Address - Country:US
Practice Address - Phone:215-247-1221
Practice Address - Fax:215-247-1179
Is Sole Proprietor?:Yes
Enumeration Date:2012-07-18
Last Update Date:2012-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARP039229L183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist