Provider Demographics
NPI:1124312897
Name:MEEKS, JEFF DAVID (PHARMD)
Entity type:Individual
Prefix:DR
First Name:JEFF
Middle Name:DAVID
Last Name:MEEKS
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:890 E HOBSON WAY
Mailing Address - Street 2:
Mailing Address - City:BLYTHE
Mailing Address - State:CA
Mailing Address - Zip Code:92225-1800
Mailing Address - Country:US
Mailing Address - Phone:760-922-9867
Mailing Address - Fax:760-922-6706
Practice Address - Street 1:890 E HOBSON WAY
Practice Address - Street 2:
Practice Address - City:BLYTHE
Practice Address - State:CA
Practice Address - Zip Code:92225-1800
Practice Address - Country:US
Practice Address - Phone:760-922-9867
Practice Address - Fax:760-922-6706
Is Sole Proprietor?:Yes
Enumeration Date:2011-05-30
Last Update Date:2011-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA52067183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist