Provider Demographics
NPI:1336372556
Name:ROSS, MEGHAN (PHARMD)
Entity Type:Individual
Prefix:
First Name:MEGHAN
Middle Name:
Last Name:ROSS
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 1:2400 UNSER BLVD SE STE 18008
Mailing Address - Street 2:
Mailing Address - City:RIO RANCHO
Mailing Address - State:NM
Mailing Address - Zip Code:87124-4740
Mailing Address - Country:US
Mailing Address - Phone:505-253-6015
Mailing Address - Fax:505-253-6016
Practice Address - Street 1:2500 MAIN ST NE
Practice Address - Street 2:
Practice Address - City:LOS LUNAS
Practice Address - State:NM
Practice Address - Zip Code:87031-6340
Practice Address - Country:US
Practice Address - Phone:505-865-7551
Practice Address - Fax:505-865-7018
Is Sole Proprietor?:No
Enumeration Date:2009-09-04
Last Update Date:2021-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMRP00007169183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist