Provider Demographics
NPI:1518940527
Name:MEADOWS, LAREN G (RPH)
Entity type:Individual
Prefix:MR
First Name:LAREN
Middle Name:G
Last Name:MEADOWS
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1558 WEST HIGH ST
Mailing Address - Street 2:
Mailing Address - City:DICKINSON
Mailing Address - State:ND
Mailing Address - Zip Code:58601
Mailing Address - Country:US
Mailing Address - Phone:701-227-8265
Mailing Address - Fax:701-227-8789
Practice Address - Street 1:431 WEST VILLARD
Practice Address - Street 2:THE MEDICINE SHOPPE
Practice Address - City:DICKINSON
Practice Address - State:ND
Practice Address - Zip Code:58601
Practice Address - Country:US
Practice Address - Phone:701-227-8265
Practice Address - Fax:701-227-8789
Is Sole Proprietor?:Yes
Enumeration Date:2005-11-23
Last Update Date:2007-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ND3104183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist