Provider Demographics
NPI:1215338108
Name:MERRILL, JEFFREY (PHARMD)
Entity type:Individual
Prefix:
First Name:JEFFREY
Middle Name:
Last Name:MERRILL
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 1:71 WHEELERTOWN AVE
Mailing Address - Street 2:
Mailing Address - City:PIKEVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37367-5246
Mailing Address - Country:US
Mailing Address - Phone:423-447-5316
Mailing Address - Fax:423-447-5283
Practice Address - Street 1:4542 HIGHWAY 58
Practice Address - Street 2:
Practice Address - City:CHATTANOOGA
Practice Address - State:TN
Practice Address - Zip Code:37416-3009
Practice Address - Country:US
Practice Address - Phone:423-892-6787
Practice Address - Fax:423-892-4621
Is Sole Proprietor?:No
Enumeration Date:2014-09-10
Last Update Date:2023-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARPH027841183500000X
TN38395183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist