Provider Demographics
NPI:1063016236
Name:LANNING, MERYL (PHARMD)
Entity Type:Individual
Prefix:
First Name:MERYL
Middle Name:
Last Name:LANNING
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 683872
Mailing Address - Street 2:
Mailing Address - City:MARIETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30068-0065
Mailing Address - Country:US
Mailing Address - Phone:131-435-9917
Mailing Address - Fax:
Practice Address - Street 1:3401 NORTHSIDE PKWY NW
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30327-2323
Practice Address - Country:US
Practice Address - Phone:404-261-7123
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-11-28
Last Update Date:2021-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARPH029783183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist