MEDICARE: MS. MELINDA L REDPATH

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	183500000X	Pharmacist	25632	TX
2	1835P0018X	Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist	TX25632	TX

General Provider Information

NPI Number	:	1083941140
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. MELINDA L REDPATH

Provider Business Mailing Address
First Line	:	606 ENNIS AVE.
Second Line	:
City	:	ENNIS
State	:	TX
Zip	:	75119
Country	:	US
Telephone Number	:	972-875-5996
Fax Number	:

Provider Business Practice Location Address
First Line	:	606 W ENNIS AVE
Second Line	:
City	:	ENNIS
State	:	TX
Zip	:	75119-3806
Country	:	US
Telephone Number	:	972-875-5996
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/11/2009
Last Update Date	:	11/11/2009

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Directions to “ MS. MELINDA L REDPATH ” Practice Location

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