Provider Demographics
NPI:1982009627
Name:O'DELL, MEISSA CIKANOWICK (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:MEISSA
Middle Name:CIKANOWICK
Last Name:O'DELL
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 1:130 HIGHWAY 252
Mailing Address - Street 2:
Mailing Address - City:ANDERSON
Mailing Address - State:SC
Mailing Address - Zip Code:29621-5054
Mailing Address - Country:US
Mailing Address - Phone:864-965-9760
Mailing Address - Fax:864-965-9872
Practice Address - Street 1:130 HIGHWAY 252
Practice Address - Street 2:
Practice Address - City:ANDERSON
Practice Address - State:SC
Practice Address - Zip Code:29621-5054
Practice Address - Country:US
Practice Address - Phone:864-965-9760
Practice Address - Fax:864-965-9872
Is Sole Proprietor?:No
Enumeration Date:2014-10-23
Last Update Date:2018-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC35574183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist