Provider Demographics
NPI:1265453211
Name:MERCALIS INC.
Entity Type:Organization
Organization Name:MERCALIS INC.
Other - Org Name:MERCALIS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JACK
Authorized Official - Middle Name:MICHAEL
Authorized Official - Last Name:MCGUIRE
Authorized Official - Suffix:
Authorized Official - Credentials:PHARMD
Authorized Official - Phone:877-343-1238
Mailing Address - Street 1:2250 PERIMETER PARK DR
Mailing Address - Street 2:SUITE 300
Mailing Address - City:MORRISVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:27560-8892
Mailing Address - Country:US
Mailing Address - Phone:919-845-0774
Mailing Address - Fax:
Practice Address - Street 1:2250 PERIMETER PARK DR
Practice Address - Street 2:SUITE 300
Practice Address - City:MORRISVILLE
Practice Address - State:NC
Practice Address - Zip Code:27560-8892
Practice Address - Country:US
Practice Address - Phone:919-845-0774
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-22
Last Update Date:2024-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
333600000X
NC095503336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC15372OtherBOARD OF PHARMACY PERMIT
2069683OtherPK