Provider Demographics
NPI:1467749077
Name:PECKEL, MEREDITH CUNDEY (PHARM D)
Entity type:Individual
Prefix:
First Name:MEREDITH
Middle Name:CUNDEY
Last Name:PECKEL
Suffix:
Gender:F
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:239 DIXON CT
Mailing Address - Street 2:
Mailing Address - City:EVANS
Mailing Address - State:GA
Mailing Address - Zip Code:30809-4302
Mailing Address - Country:US
Mailing Address - Phone:706-860-4991
Mailing Address - Fax:
Practice Address - Street 1:1647 GORDON HWY
Practice Address - Street 2:
Practice Address - City:AUGUSTA
Practice Address - State:GA
Practice Address - Zip Code:30906-2297
Practice Address - Country:US
Practice Address - Phone:706-738-5451
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-07-03
Last Update Date:2011-07-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA0226201835P1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P1200XPharmacy Service ProvidersPharmacistPharmacotherapy