Healthcare Provider Details

I. General information

NPI: 1972775161
Provider Name (Legal Business Name): MELISSA RENEE VIOLANTE PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/27/2008
Last Update Date: 03/27/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5440 PEACH ST
ERIE PA
16509
US

IV. Provider business mailing address

823 LONG POINT DR
ERIE PA
16505-5419
US

V. Phone/Fax

Practice location:
  • Phone: 814-868-4624
  • Fax:
Mailing address:
  • Phone: 814-455-4950
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberRP440622
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: