Healthcare Provider Details

I. General information

NPI: 1912827726
Provider Name (Legal Business Name): TENLEY MERRETT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/20/2026
Last Update Date: 07/20/2026
Certification Date: 07/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

940 BELMONT ST
BROCKTON MA
02301-5568
US

IV. Provider business mailing address

6 HIGH ST
MERRIMAC MA
01860-2303
US

V. Phone/Fax

Practice location:
  • Phone: 774-826-3116
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberPH241152
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: