Provider Demographics
NPI:1851686471
Name:MERONO, MEIGHAN BARTHOLOMEW (PHARMD)
Entity Type:Individual
Prefix:MRS
First Name:MEIGHAN
Middle Name:BARTHOLOMEW
Last Name:MERONO
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:MS
Other - First Name:MEIGHAN
Other - Middle Name:FAIRLEIGH
Other - Last Name:BARTHOLOMEW
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PHARMD
Mailing Address - Street 1:990 AVENIDA VISTA HERMOSA
Mailing Address - Street 2:
Mailing Address - City:SAN CLEMENTE
Mailing Address - State:CA
Mailing Address - Zip Code:92673
Mailing Address - Country:US
Mailing Address - Phone:949-456-8669
Mailing Address - Fax:
Practice Address - Street 1:990 AVENIDA VISTA HERMOSA
Practice Address - Street 2:
Practice Address - City:SAN CLEMENTE
Practice Address - State:CA
Practice Address - Zip Code:92673
Practice Address - Country:US
Practice Address - Phone:949-456-8669
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-06-10
Last Update Date:2011-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA59655183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist