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General NPI Number Information
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NPI Number | 1841597226
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Entity Type | Individual
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Provider Name | MARIA DE LOURDES MERCHAN RPH
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Gender | Female
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Dates
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Enumeration Date | 02/18/2011
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Last Update Date | 02/18/2011
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Provider Practice Location Address
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Address Line | 5505 BUFORD HWY
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City | NORCROSS
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State | GA
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Zip | 30071-3901
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Country | US
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Telephone | 770-441-9220
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Fax |
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Provider Business Mailing Address
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Address Line | 3083 CLAIBORNE DR
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City | DULUTH
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State | GA
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Zip | 30096-3719
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Country | US
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Telephone | 678-480-3687
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Fax |
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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 | 018472
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License Number State | GA
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