Provider Demographics
NPI:1972965101
Name:JAHNKE, MEGHAN DICKEY (PHARMD)
Entity Type:Individual
Prefix:
First Name:MEGHAN
Middle Name:DICKEY
Last Name:JAHNKE
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:411 MUSGROVE ST
Mailing Address - Street 2:APT 103
Mailing Address - City:CLINTON
Mailing Address - State:SC
Mailing Address - Zip Code:29325-1780
Mailing Address - Country:US
Mailing Address - Phone:704-214-0574
Mailing Address - Fax:
Practice Address - Street 1:820 N MAIN ST
Practice Address - Street 2:
Practice Address - City:WOODRUFF
Practice Address - State:SC
Practice Address - Zip Code:29388-9001
Practice Address - Country:US
Practice Address - Phone:864-476-0463
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-03-26
Last Update Date:2016-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC36472183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist