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NPI 1528099702

NPI 1528099702 : LEE MERRITT RPH : COLUMBUS, MS

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General NPI Number Information
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    NPI Number           |    1528099702
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    Entity Type          |    Individual 
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    Provider Name        |    LEE MERRITT RPH
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    Gender               |    Male 
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Dates
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    Enumeration Date     |    07/05/2006
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    Last Update Date     |    07/08/2007
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Provider Practice Location Address
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    Address Line         |    2211 5TH ST N SUITE B
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    City                 |    COLUMBUS
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    State                |    MS
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    Zip                  |    39705-2211
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    Country              |    US
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    Telephone            |    662-240-8900
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    Fax                  |    662-240-8966
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Provider Business Mailing Address
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    Address Line         |    2211 5TH ST N SUITE B
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    City                 |    COLUMBUS
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    State                |    MS
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    Zip                  |    39705-2211
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    Country              |    US
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    Telephone            |    662-240-8900
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    Fax                  |    662-240-8966
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Authorized Official
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    Title or Position    |    
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    Name                 |        
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    Credential           |    
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    Telephone            |    
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    183500000X
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    Taxonomy Name        |    Pharmacist
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    License Number       |    T08739
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    License Number State |    MS
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