Organization
MERCY MEDICAL PARTNERS NORTHERN REGION LLC
Active
Other names
Mercy Defiance Clinic Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
MICHELLE INKROTT (PHARMACY MANAGER)
(419) 783-3376
Entity
Organization
Contact information
Practice address
1400 E 2ND ST, DEFIANCE, OH 43512-2440
(419) 783-3376
(419) 783-3378
Mailing address
1400 E 2ND ST, DEFIANCE, OH 43512-2440
(419) 783-3376
(419) 783-3378
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
RTP022169900
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0061418
—
OH
01
—
2133639
PK
—
Enumeration date
08/15/2006
Last updated
03/29/2016
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