Healthcare Provider Details

I. General information

NPI: 1376290627
Provider Name (Legal Business Name): MELINDA FRIDAY RPH
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/07/2022
Last Update Date: 03/07/2022
Certification Date: 03/07/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

27 HECKEL RD
MC KEES ROCKS PA
15136-1616
US

IV. Provider business mailing address

2130 SHAWNEE DR
WASHINGTON PA
15301-5020
US

V. Phone/Fax

Practice location:
  • Phone: 412-771-2149
  • Fax:
Mailing address:
  • Phone: 724-413-2556
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835P0018X
TaxonomyPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
License NumberRP035943L
License Number StatePA

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

# 1
IdentifierRP035943L
Identifier TypeOTHER
Identifier StatePA
Identifier IssuerPHARMACIST LICENSE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: