Provider Demographics
NPI:1407444375
Name:MERRITT, TYLER EDWARD (PHARMD)
Entity Type:Individual
Prefix:
First Name:TYLER
Middle Name:EDWARD
Last Name:MERRITT
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1055 STILLWELL DR UNIT 1237
Mailing Address - Street 2:
Mailing Address - City:DURHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27707-6368
Mailing Address - Country:US
Mailing Address - Phone:931-224-4905
Mailing Address - Fax:
Practice Address - Street 1:1055 STILLWELL DR UNIT 1237
Practice Address - Street 2:
Practice Address - City:DURHAM
Practice Address - State:NC
Practice Address - Zip Code:27707-6368
Practice Address - Country:US
Practice Address - Phone:931-224-4905
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-01-06
Last Update Date:2021-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC29497183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist