Provider Demographics
NPI:1477954170
Name:MAGUNDAYAO, MERCE J (PHARMD)
Entity Type:Individual
Prefix:
First Name:MERCE
Middle Name:J
Last Name:MAGUNDAYAO
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1031 BLUE SKY DR
Mailing Address - Street 2:
Mailing Address - City:CONCORD
Mailing Address - State:NC
Mailing Address - Zip Code:28027-7971
Mailing Address - Country:US
Mailing Address - Phone:954-829-4209
Mailing Address - Fax:
Practice Address - Street 1:10 PITTS SCHOOL RD NW
Practice Address - Street 2:
Practice Address - City:CONCORD
Practice Address - State:NC
Practice Address - Zip Code:28027-0302
Practice Address - Country:US
Practice Address - Phone:952-829-4209
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-09-12
Last Update Date:2014-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC24587183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist