Healthcare Provider Details

I. General information

NPI: 1689101719
Provider Name (Legal Business Name): MELINDA SUE AAMODT RPH
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/19/2017
Last Update Date: 06/17/2026
Certification Date: 06/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

800 W COSHOCTON ST
JOHNSTOWN OH
43031-8904
US

IV. Provider business mailing address

124 HIDDEN HILLS DR
PATASKALA OH
43062-8068
US

V. Phone/Fax

Practice location:
  • Phone: 740-966-8310
  • Fax: 740-966-8312
Mailing address:
  • Phone: 614-313-1028
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835P0018X
TaxonomyPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
License Number03124390
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: