Healthcare Provider Details

I. General information

NPI: 1124320528
Provider Name (Legal Business Name): MELANIE PRYOR PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/17/2010
Last Update Date: 11/24/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7561 W 80TH AVE
ARVADA CO
80003-2113
US

IV. Provider business mailing address

7561 WEST 80TH AVE.
ARVADA CO
80005
US

V. Phone/Fax

Practice location:
  • Phone: 303-425-0371
  • Fax:
Mailing address:
  • Phone: 303-425-0371
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number18257
License Number StateCO
# 2
Primary TaxonomyN
Taxonomy Code183500000X
TaxonomyPharmacist
License Number12941
License Number StateNE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: