1811605801 NPI number — MEREDITH LINDSAY MAGNELLI PHARMD

Table of content: MEREDITH LINDSAY MAGNELLI PHARMD (NPI 1811605801)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1811605801 NPI number — MEREDITH LINDSAY MAGNELLI PHARMD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
MAGNELLI
Provider First Name:
MEREDITH
Provider Middle Name:
LINDSAY
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
PHARMD
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
HUDSON
Provider Other First Name:
MEREDITH
Provider Other Middle Name:
LINDSAY
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
PHARMD
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1811605801
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
11/09/2022
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
6395 SHERIDAN BLVD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
ARVADA
Provider Business Mailing Address State Name:
CO
Provider Business Mailing Address Postal Code:
80003-5231
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
303-420-7545
Provider Business Mailing Address Fax Number:
303-420-8603

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
6395 SHERIDAN BLVD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
ARVADA
Provider Business Practice Location Address State Name:
CO
Provider Business Practice Location Address Postal Code:
80003-5231
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
303-420-7545
Provider Business Practice Location Address Fax Number:
303-420-8603
Provider Enumeration Date:
11/09/2022

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 183500000X , with the licence number:  21552 , registered in the state of CO ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)