Provider Demographics
NPI:1124506035
Name:DOLLY, MEGHAN ALEXA (PHARMD)
Entity type:Individual
Prefix:MISS
First Name:MEGHAN
Middle Name:ALEXA
Last Name:DOLLY
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 1:3601 SOUTH 6TH AVENUE
Mailing Address - Street 2:1-119 PHARMACY SERVICE
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85723
Mailing Address - Country:US
Mailing Address - Phone:205-792-1450
Mailing Address - Fax:520-838-3617
Practice Address - Street 1:3601 S 6TH AVE
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85723-3620
Practice Address - Country:US
Practice Address - Phone:205-792-1450
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-08-02
Last Update Date:2022-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC37844183500000X, 1835P2201X, 1835P1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P1200XPharmacy Service ProvidersPharmacistPharmacotherapy
No183500000XPharmacy Service ProvidersPharmacist
No1835P2201XPharmacy Service ProvidersPharmacistAmbulatory Care