Healthcare Provider Details

I. General information

NPI: 1932707312
Provider Name (Legal Business Name): MELISSA CHANDLER
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/16/2020
Last Update Date: 05/26/2026
Certification Date: 05/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

601 WOODMAN DR
DAYTON OH
45431-2731
US

IV. Provider business mailing address

10210 GULLY PASS DR
DAYTON OH
45458-4370
US

V. Phone/Fax

Practice location:
  • Phone: 937-535-5820
  • Fax:
Mailing address:
  • Phone: 937-535-5820
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835P0018X
TaxonomyPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
License Number26023619A
License Number StateIN
# 2
Primary TaxonomyN
Taxonomy Code1835P0018X
TaxonomyPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
License Number03438411
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: