Provider Demographics
NPI:1881286128
Name:KELDERHOUSE, MEREDITH GRAY (PHARMD)
Entity type:Individual
Prefix:DR
First Name:MEREDITH
Middle Name:GRAY
Last Name:KELDERHOUSE
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 1:72 PINERIDGE LN
Mailing Address - Street 2:
Mailing Address - City:SURRY
Mailing Address - State:VA
Mailing Address - Zip Code:23883-3110
Mailing Address - Country:US
Mailing Address - Phone:540-589-2736
Mailing Address - Fax:
Practice Address - Street 1:1310 JAMESTOWN RD
Practice Address - Street 2:
Practice Address - City:WILLIAMSBURG
Practice Address - State:VA
Practice Address - Zip Code:23185-3309
Practice Address - Country:US
Practice Address - Phone:757-229-2560
Practice Address - Fax:757-253-5651
Is Sole Proprietor?:Yes
Enumeration Date:2021-02-08
Last Update Date:2021-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA02022190271835P0018X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P0018XPharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist