MEDICARE: MELISSA CHANDLER

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	1835P0018X	Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist	26023619A	IN
2	1835P0018X	Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist	03438411	OH

General Provider Information

NPI Number	:	1932707312
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MELISSA CHANDLER

Provider Business Mailing Address
First Line	:	10210 GULLY PASS DR
Second Line	:
City	:	DAYTON
State	:	OH
Zip	:	45458-4370
Country	:	US
Telephone Number	:	937-535-5820
Fax Number	:

Provider Business Practice Location Address
First Line	:	601 WOODMAN DR
Second Line	:
City	:	DAYTON
State	:	OH
Zip	:	45431-2731
Country	:	US
Telephone Number	:	937-535-5820
Fax Number	:

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

Provider Enumeration Date	:	10/16/2020
Last Update Date	:	05/26/2026

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Directions to “ MELISSA CHANDLER ” Practice Location

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