Provider Demographics
NPI:1407130255
Name:JOHNSON, MERCY (RPH)
Entity Type:Individual
Prefix:MRS
First Name:MERCY
Middle Name:
Last Name:JOHNSON
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:699 W GERMANTOWN PIKE
Mailing Address - Street 2:
Mailing Address - City:EAST NORRITON
Mailing Address - State:PA
Mailing Address - Zip Code:19403-4233
Mailing Address - Country:US
Mailing Address - Phone:610-630-5819
Mailing Address - Fax:610-630-2474
Practice Address - Street 1:699 W GERMANTOWN PIKE
Practice Address - Street 2:
Practice Address - City:EAST NORRITON
Practice Address - State:PA
Practice Address - Zip Code:19403-4233
Practice Address - Country:US
Practice Address - Phone:610-630-5819
Practice Address - Fax:610-630-2474
Is Sole Proprietor?:No
Enumeration Date:2011-09-28
Last Update Date:2011-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARP042350L183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist