Provider Demographics
NPI:1881884377
Name:ROSS, MERILYN DUNN (RPH)
Entity type:Individual
Prefix:
First Name:MERILYN
Middle Name:DUNN
Last Name:ROSS
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:PO BOX 157
Mailing Address - Street 2:
Mailing Address - City:SCOTIA
Mailing Address - State:CA
Mailing Address - Zip Code:95565-0157
Mailing Address - Country:US
Mailing Address - Phone:707-764-3591
Mailing Address - Fax:707-764-3797
Practice Address - Street 1:113 MAIN ST
Practice Address - Street 2:SUITE D
Practice Address - City:SCOTIA
Practice Address - State:CA
Practice Address - Zip Code:95565-0157
Practice Address - Country:US
Practice Address - Phone:707-764-3591
Practice Address - Fax:707-764-3797
Is Sole Proprietor?:No
Enumeration Date:2007-07-31
Last Update Date:2007-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CARPH36937183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist