Provider Demographics
NPI:1386475697
Name:GREENE, MEGAN WAKLEY (PHARMD)
Entity type:Individual
Prefix:
First Name:MEGAN
Middle Name:WAKLEY
Last Name:GREENE
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 1:520 WALDO ST
Mailing Address - Street 2:
Mailing Address - City:RUMFORD
Mailing Address - State:ME
Mailing Address - Zip Code:04276-1617
Mailing Address - Country:US
Mailing Address - Phone:371-120-7364
Mailing Address - Fax:
Practice Address - Street 1:520 WALDO ST
Practice Address - Street 2:
Practice Address - City:RUMFORD
Practice Address - State:ME
Practice Address - Zip Code:04276-1617
Practice Address - Country:US
Practice Address - Phone:371-120-7364
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-08-08
Last Update Date:2024-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MEPR72158183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist