Provider Demographics
NPI:1912276171
Name:BRANHAM, MEGAN KATHLEEN (PHARMD, RPH)
Entity Type:Individual
Prefix:MS
First Name:MEGAN
Middle Name:KATHLEEN
Last Name:BRANHAM
Suffix:
Gender:F
Credentials:PHARMD, RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1089 GABRIELLE ELAINE DR APT 202
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43228-8833
Mailing Address - Country:US
Mailing Address - Phone:937-728-9524
Mailing Address - Fax:
Practice Address - Street 1:4211 TRUEMAN BLVD
Practice Address - Street 2:
Practice Address - City:HILLIARD
Practice Address - State:OH
Practice Address - Zip Code:43026-2480
Practice Address - Country:US
Practice Address - Phone:614-876-7089
Practice Address - Fax:614-219-5109
Is Sole Proprietor?:No
Enumeration Date:2011-12-17
Last Update Date:2015-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH03334817183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist