Provider Demographics
NPI:1407464241
Name:FLANAGAN, MERCEDEZ PAIGE (PHARM D)
Entity Type:Individual
Prefix:DR
First Name:MERCEDEZ
Middle Name:PAIGE
Last Name:FLANAGAN
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 1:1287 RED OAK DR
Mailing Address - Street 2:
Mailing Address - City:ALMA
Mailing Address - State:AR
Mailing Address - Zip Code:72921
Mailing Address - Country:US
Mailing Address - Phone:479-208-2069
Mailing Address - Fax:
Practice Address - Street 1:1287 RED OAK DR
Practice Address - Street 2:
Practice Address - City:ALMA
Practice Address - State:AR
Practice Address - Zip Code:72921
Practice Address - Country:US
Practice Address - Phone:479-208-2069
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-07-17
Last Update Date:2020-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARPD14604183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist