Provider Demographics
NPI:1669646063
Name:MERRIFIELD, JODI ANN (RPH)
Entity Type:Individual
Prefix:MRS
First Name:JODI
Middle Name:ANN
Last Name:MERRIFIELD
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 1:51037 VAN DYKE AVE
Mailing Address - Street 2:
Mailing Address - City:SHELBY TWP
Mailing Address - State:MI
Mailing Address - Zip Code:48316-4438
Mailing Address - Country:US
Mailing Address - Phone:586-739-1100
Mailing Address - Fax:586-739-5280
Practice Address - Street 1:51037 VAN DYKE AVE
Practice Address - Street 2:
Practice Address - City:SHELBY TWP
Practice Address - State:MI
Practice Address - Zip Code:48316-4438
Practice Address - Country:US
Practice Address - Phone:586-739-1100
Practice Address - Fax:586-739-5280
Is Sole Proprietor?:No
Enumeration Date:2008-04-16
Last Update Date:2008-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5302028510183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist