Provider Demographics
NPI:1598828626
Name:AUSTIN, MERCEDES (BS PHARM,RPH)
Entity type:Individual
Prefix:
First Name:MERCEDES
Middle Name:
Last Name:AUSTIN
Suffix:
Gender:F
Credentials:BS PHARM,RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3973 BOURBON ST
Mailing Address - Street 2:
Mailing Address - City:TALLAHASSEE
Mailing Address - State:FL
Mailing Address - Zip Code:32303-2035
Mailing Address - Country:US
Mailing Address - Phone:850-960-5480
Mailing Address - Fax:
Practice Address - Street 1:407 E BASE ST
Practice Address - Street 2:
Practice Address - City:MADISON
Practice Address - State:FL
Practice Address - Zip Code:32340-2769
Practice Address - Country:US
Practice Address - Phone:850-973-3019
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-19
Last Update Date:2024-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS26423183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist