Healthcare Provider Details

I. General information

NPI: 1972052256
Provider Name (Legal Business Name): MELEANE RILEY
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/27/2016
Last Update Date: 09/05/2026
Certification Date: 09/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1735 HECKLE BLVD
ROCK HILL SC
29732-4803
US

IV. Provider business mailing address

1735 HECKLE BLVD
ROCK HILL SC
29732-4803
US

V. Phone/Fax

Practice location:
  • Phone: 803-372-6369
  • Fax:
Mailing address:
  • Phone: 803-372-6369
  • Fax: 844-830-2951

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number36917
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: