Provider Demographics
NPI:1881170066
Name:SCHRUMPF, MEGHAN (PHARMD)
Entity type:Individual
Prefix:
First Name:MEGHAN
Middle Name:
Last Name:SCHRUMPF
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 1:2712 GODFREY RD
Mailing Address - Street 2:
Mailing Address - City:GODFREY
Mailing Address - State:IL
Mailing Address - Zip Code:62035-3311
Mailing Address - Country:US
Mailing Address - Phone:618-466-0825
Mailing Address - Fax:618-467-0544
Practice Address - Street 1:2712 GODFREY RD
Practice Address - Street 2:
Practice Address - City:GODFREY
Practice Address - State:IL
Practice Address - Zip Code:62035-3311
Practice Address - Country:US
Practice Address - Phone:618-466-0825
Practice Address - Fax:618-467-0544
Is Sole Proprietor?:Yes
Enumeration Date:2018-07-11
Last Update Date:2018-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL051-289269183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist