1407866825 NPI number — MERL INC

Table of content: (NPI 1407866825)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1407866825 NPI number — MERL INC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
MERL INC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
HOAGLAND LTC PHARMACY
Provider Other Organization Name Type Code:
3
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1407866825
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
05/14/2021
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2330 YEW ST
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
BELLINGHAM
Provider Business Mailing Address State Name:
WA
Provider Business Mailing Address Postal Code:
98229-3942
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
360-734-5413
Provider Business Mailing Address Fax Number:
360-734-1454

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1414 MEADOR AVE
Provider Second Line Business Practice Location Address:
H102
Provider Business Practice Location Address City Name:
BELLINGHAM
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
98229-5833
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
360-734-7544
Provider Business Practice Location Address Fax Number:
360-734-7547
Provider Enumeration Date:
08/08/2006

Additional Information

Authorized Official

Authorized Official Last Name:
STEPHENS
Authorized Official First Name:
CARRIE
Authorized Official Middle Name:
Authorized Official Title or Position:
OWNER/TREASURER
Authorized Official Telephone Number:
360-685-5012

Provider Taxonomy Codes

  • Taxonomy code: 332B00000X , with the licence number:  FL00056477 , registered in the state of WA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 332BP3500X , with the licence number: FL00056477 , registered in the state of WA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 332BX2000X , with the licence number: FL00056477 , registered in the state of WA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 3336C0004X , with the licence number: FL00056477 , registered in the state of WA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 3336L0003X , with the licence number: FL00056477 , registered in the state of WA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 216123 . This is a "WASHINGTON L&I" identifier , issued by the state of ( WA ) . This identifiers is of the category "OTHER".
  • Identifier: 15851001 . This is a "GROUP HEALTH PROVIDER" identifier , issued by the state of ( WA ) . This identifiers is of the category "OTHER".
  • Identifier: 4929761 . This is a "NCPDP/NABP" identifier , issued by the state of ( WA ) . This identifiers is of the category "OTHER".
  • Identifier: 6029417 , issued by the state of ( WA ) . This identifiers is of the category "MEDICAID".




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