Provider Demographics
NPI:1932493848
Name:MERRIFIELD, DAVID W (RPH)
Entity Type:Individual
Prefix:
First Name:DAVID
Middle Name:W
Last Name:MERRIFIELD
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3938 MIDWAY RD
Mailing Address - Street 2:T-1446
Mailing Address - City:GOSHEN
Mailing Address - State:IN
Mailing Address - Zip Code:46526-5854
Mailing Address - Country:US
Mailing Address - Phone:574-875-0610
Mailing Address - Fax:
Practice Address - Street 1:3938 MIDWAY RD
Practice Address - Street 2:T-1446
Practice Address - City:GOSHEN
Practice Address - State:IN
Practice Address - Zip Code:46526-5854
Practice Address - Country:US
Practice Address - Phone:574-875-0610
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-06-08
Last Update Date:2011-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN26015002A183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist