MEDICARE: MRS. MELISSA MORGAN O'FERRALL RPH

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	RPH017771	GA

General Provider Information

NPI Number	:	1922216399
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. MELISSA MORGAN O'FERRALL RPH

Provider Business Mailing Address
First Line	:	173 GATEWAY DR
Second Line	:
City	:	ROCKY FACE
State	:	GA
Zip	:	30740-8946
Country	:	US
Telephone Number	:	706-226-0098
Fax Number	:

Provider Business Practice Location Address
First Line	:	1710 CLEVELAND HWY
Second Line	:
City	:	DALTON
State	:	GA
Zip	:	30721-8313
Country	:	US
Telephone Number	:	706-259-9787
Fax Number	:

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

Provider Enumeration Date	:	05/18/2007
Last Update Date	:	07/08/2007

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