Healthcare Provider Details

I. General information

NPI: 1275000531
Provider Name (Legal Business Name): MELANIE CAHOON RPH
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/25/2018
Last Update Date: 10/25/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

210 S HWY 64
MANTEO NC
27954
US

IV. Provider business mailing address

2616 S COMPASS LN
NAGS HEAD NC
27959-9526
US

V. Phone/Fax

Practice location:
  • Phone: 252-473-5801
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number09006
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: