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General NPI Number Information
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NPI Number | 1003181835
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Entity Type | Organization
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Legal Business Name | MELODY PHARMACY INC
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Dates
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Enumeration Date | 03/12/2012
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Last Update Date | 03/10/2017
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Provider Practice Location Address
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Address Line | 17639 NW 27TH AVE
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City | MIAMI GARDENS
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State | FL
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Zip | 33056-4007
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Country | US
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Telephone | 305-625-0018
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Fax | 305-625-0020
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Provider Business Mailing Address
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Address Line | 17639 NW 27TH AVE
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City | MIAMI GARDENS
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State | FL
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Zip | 33056-4007
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Country | US
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Telephone | 305-625-0018
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Fax | 305-625-0020
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Authorized Official
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Title or Position | PRESIDENT, RPH
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Name | MICHAEL EGBERONGBE
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Credential |
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Telephone | 305-625-0018
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 333600000X
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Taxonomy Name | Pharmacy
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number | PH26044
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License Number State | FL
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