Provider Demographics
NPI:1962126292
Name:MURDOCK, MARCIA ELAINE
Entity type:Individual
Prefix:
First Name:MARCIA
Middle Name:ELAINE
Last Name:MURDOCK
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6766 SILVER RIDGE LN
Mailing Address - Street 2:
Mailing Address - City:GREENACRES
Mailing Address - State:FL
Mailing Address - Zip Code:33413-3441
Mailing Address - Country:US
Mailing Address - Phone:561-207-1512
Mailing Address - Fax:
Practice Address - Street 1:2220 S US HIGHWAY 1
Practice Address - Street 2:
Practice Address - City:FORT PIERCE
Practice Address - State:FL
Practice Address - Zip Code:34950-5154
Practice Address - Country:US
Practice Address - Phone:772-464-0434
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-09-29
Last Update Date:2022-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333600000XSuppliersPharmacy