Provider Demographics
NPI:1912868811
Name:MERRITT, ROBERT
Entity type:Individual
Prefix:
First Name:ROBERT
Middle Name:
Last Name:MERRITT
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9588 CEMETERY RD
Mailing Address - Street 2:
Mailing Address - City:DE GRAFF
Mailing Address - State:OH
Mailing Address - Zip Code:43318-9547
Mailing Address - Country:US
Mailing Address - Phone:937-597-4961
Mailing Address - Fax:
Practice Address - Street 1:9588 CEMETERY RD
Practice Address - Street 2:
Practice Address - City:DE GRAFF
Practice Address - State:OH
Practice Address - Zip Code:43318-9547
Practice Address - Country:US
Practice Address - Phone:937-597-4961
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-11-20
Last Update Date:2025-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH253Z00000X, 347C00000X, 3747P1801X, 347E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant
No253Z00000XAgenciesIn Home Supportive Care
No347C00000XTransportation ServicesPrivate Vehicle
No347E00000XTransportation ServicesTransportation Broker