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General NPI Number Information
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NPI Number | 1508120395
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Entity Type | Organization
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Legal Business Name | MERRITT ISLAND PHARMACY
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Dates
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Enumeration Date | 06/27/2012
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Last Update Date | 09/19/2025
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Provider Practice Location Address
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Address Line | 35 N COURTENAY PKWY
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City | MERRITT ISLAND
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State | FL
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Zip | 32953-3476
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Country | US
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Telephone | 321-454-0911
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Fax | 321-459-2479
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Provider Business Mailing Address
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Address Line | 35 N COURTENAY PKWY
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City | MERRITT ISLAND
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State | FL
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Zip | 32953-3476
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Country | US
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Telephone | 321-454-0911
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Fax | 321-459-2479
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Authorized Official
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Title or Position | PHARMACY MANAGER, PIC
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Name | BHAVIN DHADUK
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Credential | RPH
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Telephone | 201-916-7125
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 333600000X
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Taxonomy Name | Pharmacy
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 3336L0003X
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Taxonomy Name | Long Term Care Pharmacy
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number | PH26203
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License Number State | FL
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