Provider Demographics
NPI:1538414594
Name:BALL, MEGAN KATHERINE (PHARMD)
Entity type:Individual
Prefix:DR
First Name:MEGAN
Middle Name:KATHERINE
Last Name:BALL
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:DR
Other - First Name:MEGAN
Other - Middle Name:KATHERINE
Other - Last Name:SULLIVAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PHARMD
Mailing Address - Street 1:11 LAURELTON DR
Mailing Address - Street 2:
Mailing Address - City:WEST SENECA
Mailing Address - State:NY
Mailing Address - Zip Code:14224-3909
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:20 LAWRENCE BELL DR
Practice Address - Street 2:SUITE 100
Practice Address - City:WILLIAMSVILLE
Practice Address - State:NY
Practice Address - Zip Code:14221-7074
Practice Address - Country:US
Practice Address - Phone:716-204-9060
Practice Address - Fax:716-204-9061
Is Sole Proprietor?:Yes
Enumeration Date:2012-07-16
Last Update Date:2013-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY056912183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist