Provider Demographics
NPI:1528337268
Name:MEIKLE, BRIAN (RPH)
Entity type:Individual
Prefix:MR
First Name:BRIAN
Middle Name:
Last Name:MEIKLE
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3775 GREENBRIAR WAY
Mailing Address - Street 2:
Mailing Address - City:SALT LAKE CITY
Mailing Address - State:UT
Mailing Address - Zip Code:84109-3355
Mailing Address - Country:US
Mailing Address - Phone:801-274-1925
Mailing Address - Fax:
Practice Address - Street 1:3291 HIGHLAND DRIVE
Practice Address - Street 2:
Practice Address - City:SALT LAKE CITY
Practice Address - State:UT
Practice Address - Zip Code:84106-3022
Practice Address - Country:US
Practice Address - Phone:801-478-0127
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-12-27
Last Update Date:2011-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT98-320406-1701183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist