Provider Demographics
NPI:1427068832
Name:MERL INC
Entity type:Organization
Organization Name:MERL INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER/TREASURER
Authorized Official - Prefix:
Authorized Official - First Name:CARRIE
Authorized Official - Middle Name:
Authorized Official - Last Name:STEPHENS
Authorized Official - Suffix:
Authorized Official - Credentials:CPHT
Authorized Official - Phone:360-685-5012
Mailing Address - Street 1:2330 YEW ST
Mailing Address - Street 2:
Mailing Address - City:BELLINGHAM
Mailing Address - State:WA
Mailing Address - Zip Code:98229-3942
Mailing Address - Country:US
Mailing Address - Phone:360-734-5413
Mailing Address - Fax:360-734-1454
Practice Address - Street 1:2330 YEW ST
Practice Address - Street 2:
Practice Address - City:BELLINGHAM
Practice Address - State:WA
Practice Address - Zip Code:98229-3942
Practice Address - Country:US
Practice Address - Phone:360-734-5413
Practice Address - Fax:360-734-1454
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-08
Last Update Date:2021-11-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
332B00000X, 3336C0004X
WACF000020963336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No3336C0004XSuppliersPharmacyCompounding Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA15851001OtherGROUP HEALTH PROVIDER
WA4915039OtherNCPDP/NABP
WA54561OtherL&I PROVIDER
WA6009328Medicaid
WA54561OtherL&I PROVIDER