Individual
DONNA R MERIDETH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
R.PH.
Contact information
Practice address
211 S 1ST ST, ALPHA, IL 61413-5152
(309) 629-4506
(309) 629-2611
Mailing address
PO BOX 355, ALPHA, IL 61413-0355
(309) 629-4506
(309) 629-2611
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
051039108
IL
Other
Enumeration date
12/16/2020
Last updated
12/16/2020
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