Provider Demographics
NPI:1538190996
Name:BOLINGER, MEGHAN (PHARMD)
Entity type:Individual
Prefix:
First Name:MEGHAN
Middle Name:
Last Name:BOLINGER
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 1:104 PARTRIDGE CT
Mailing Address - Street 2:
Mailing Address - City:JOHNSTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:15904-3647
Mailing Address - Country:US
Mailing Address - Phone:412-260-2532
Mailing Address - Fax:412-260-2532
Practice Address - Street 1:598 GALLERIA DR
Practice Address - Street 2:
Practice Address - City:JOHNSTOWN
Practice Address - State:PA
Practice Address - Zip Code:15904-8900
Practice Address - Country:US
Practice Address - Phone:814-266-8696
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-05
Last Update Date:2018-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMA052494363AM0700X
PARP4443831835P0018X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P0018XPharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
No363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAMA052494OtherSTATE LICENSE
PARP444383OtherSTATE LICENSE