Provider Demographics
NPI:1447715339
Name:MOOREFIELD, MERITZA (RPH)
Entity type:Individual
Prefix:
First Name:MERITZA
Middle Name:
Last Name:MOOREFIELD
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 1:2964 SHEPPARD MILL RD
Mailing Address - Street 2:
Mailing Address - City:SANDY RIDGE
Mailing Address - State:NC
Mailing Address - Zip Code:27046-7036
Mailing Address - Country:US
Mailing Address - Phone:336-416-9514
Mailing Address - Fax:
Practice Address - Street 1:717 HIGHWAY ST
Practice Address - Street 2:
Practice Address - City:MADISON
Practice Address - State:NC
Practice Address - Zip Code:27025-1507
Practice Address - Country:US
Practice Address - Phone:336-548-6021
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-02-05
Last Update Date:2019-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC10508183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist