Provider Demographics
NPI:1538866223
Name:BOOS, MERIDETH (PHARMD)
Entity type:Individual
Prefix:
First Name:MERIDETH
Middle Name:
Last Name:BOOS
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 1:4008 COVENTRY LN
Mailing Address - Street 2:
Mailing Address - City:HURON
Mailing Address - State:OH
Mailing Address - Zip Code:44839-2175
Mailing Address - Country:US
Mailing Address - Phone:419-271-2995
Mailing Address - Fax:
Practice Address - Street 1:4 E LEAGUE ST
Practice Address - Street 2:
Practice Address - City:NORWALK
Practice Address - State:OH
Practice Address - Zip Code:44857-1308
Practice Address - Country:US
Practice Address - Phone:419-668-0424
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-02-13
Last Update Date:2023-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH03132352183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH00000000OtherN/A