MEDICARE: TRICIA RENEE MERRICK RPH

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	183500000X	Pharmacist	RPH022237	GA

General Provider Information

NPI Number	:	1386926905
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TRICIA RENEE MERRICK RPH

Provider Business Mailing Address
First Line	:	649 SHALLOWFORD RD NW
Second Line	:
City	:	GAINESVILLE
State	:	GA
Zip	:	30504-4146
Country	:	US
Telephone Number	:	770-614-4548
Fax Number	:

Provider Business Practice Location Address
First Line	:	649 SHALLOWFORD RD NW
Second Line	:
City	:	GAINESVILLE
State	:	GA
Zip	:	30504-4146
Country	:	US
Telephone Number	:	678-450-8847
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/10/2011
Last Update Date	:	12/21/2022

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