Provider Demographics
NPI:1902037831
Name:MENEFEE, TANYA DENISE (RPH)
Entity Type:Individual
Prefix:MS
First Name:TANYA
Middle Name:DENISE
Last Name:MENEFEE
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 1:9204 BERGER RD
Mailing Address - Street 2:SUITE A
Mailing Address - City:COLUMBIA
Mailing Address - State:MD
Mailing Address - Zip Code:21046-1729
Mailing Address - Country:US
Mailing Address - Phone:410-443-7660
Mailing Address - Fax:877-212-1420
Practice Address - Street 1:9204 BERGER RD
Practice Address - Street 2:SUITE A
Practice Address - City:COLUMBIA
Practice Address - State:MD
Practice Address - Zip Code:21046-1729
Practice Address - Country:US
Practice Address - Phone:410-443-7660
Practice Address - Fax:877-212-1420
Is Sole Proprietor?:Yes
Enumeration Date:2009-07-27
Last Update Date:2016-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD108561835P0018X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P0018XPharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist