Healthcare Provider Details

I. General information

NPI: 1104821776
Provider Name (Legal Business Name): MEL PHARM INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/20/2005
Last Update Date: 01/30/2020
Certification Date: 01/30/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

402 S. MADERA AVE STE A
MADERA CA
93637-3203
US

IV. Provider business mailing address

402 S. MADERA AVE STE A
MADERA CA
93637-3203
US

V. Phone/Fax

Practice location:
  • Phone: 559-674-8553
  • Fax: 559-674-0947
Mailing address:
  • Phone: 559-674-8553
  • Fax: 559-674-0947

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code333600000X
TaxonomyPharmacy
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License NumberPHY53630
License Number StateCA
# 4
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: MR. SIRTAJ SINGH
Title or Position: OWNER/PRESIDENT
Credential: PHARMD
Phone: 559-674-8553