Provider Demographics
NPI:1780774265
Name:MERRITT, CARL FRANCIS II (PHARMD)
Entity type:Individual
Prefix:
First Name:CARL
Middle Name:FRANCIS
Last Name:MERRITT
Suffix:II
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 1:4114 BOULDER CREEK CT
Mailing Address - Street 2:
Mailing Address - City:FAIRFIELD
Mailing Address - State:CA
Mailing Address - Zip Code:94534-6639
Mailing Address - Country:US
Mailing Address - Phone:707-645-2521
Mailing Address - Fax:707-645-2530
Practice Address - Street 1:1761 BROADWAY ST
Practice Address - Street 2:SUITE 209
Practice Address - City:VALLEJO
Practice Address - State:CA
Practice Address - Zip Code:94589
Practice Address - Country:US
Practice Address - Phone:707-645-2521
Practice Address - Fax:707-645-2530
Is Sole Proprietor?:No
Enumeration Date:2006-10-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CARPH 36552183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist