Provider Demographics
NPI:1770772915
Name:MOORMAN, MEREDITH TOMA (PHARM D)
Entity type:Individual
Prefix:MISS
First Name:MEREDITH
Middle Name:TOMA
Last Name:MOORMAN
Suffix:
Gender:F
Credentials:PHARM D
Other - Prefix:
Other - First Name:MEREDITH
Other - Middle Name:BRENNAN
Other - Last Name:TOMA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:BOX 3089
Mailing Address - Street 2:
Mailing Address - City:DURHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27710
Mailing Address - Country:US
Mailing Address - Phone:919-681-2414
Mailing Address - Fax:
Practice Address - Street 1:1 TRENT DRIVE
Practice Address - Street 2:BOX 3089
Practice Address - City:DURHAM
Practice Address - State:NC
Practice Address - Zip Code:27710
Practice Address - Country:US
Practice Address - Phone:919-681-2414
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-10-23
Last Update Date:2012-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC229391835X0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835X0200XPharmacy Service ProvidersPharmacistOncology