Provider Demographics
NPI:1114257466
Name:MEHRER, JILL (PHARM D)
Entity Type:Individual
Prefix:
First Name:JILL
Middle Name:
Last Name:MEHRER
Suffix:
Gender:F
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:325 W APACHE TRL
Mailing Address - Street 2:
Mailing Address - City:APACHE JUNCTION
Mailing Address - State:AZ
Mailing Address - Zip Code:85120-3954
Mailing Address - Country:US
Mailing Address - Phone:480-983-1129
Mailing Address - Fax:480-983-1547
Practice Address - Street 1:325 W APACHE TRL
Practice Address - Street 2:
Practice Address - City:APACHE JUNCTION
Practice Address - State:AZ
Practice Address - Zip Code:85120-3954
Practice Address - Country:US
Practice Address - Phone:480-983-1129
Practice Address - Fax:480-983-1547
Is Sole Proprietor?:No
Enumeration Date:2010-01-09
Last Update Date:2014-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ013310183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist