Provider Demographics
NPI:1699069187
Name:MEHRIZI, ALI M (PHARMD)
Entity type:Individual
Prefix:MR
First Name:ALI
Middle Name:M
Last Name:MEHRIZI
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:7860 REA RD
Mailing Address - Street 2:TARGET 1087
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28277-6502
Mailing Address - Country:US
Mailing Address - Phone:704-542-8170
Mailing Address - Fax:704-542-8170
Practice Address - Street 1:7860 REA RD
Practice Address - Street 2:TARGET 1087
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28277-6502
Practice Address - Country:US
Practice Address - Phone:704-542-8170
Practice Address - Fax:704-542-8170
Is Sole Proprietor?:Yes
Enumeration Date:2011-06-02
Last Update Date:2011-06-02
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NC20444183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist