=====================================================
General NPI Number Information
=====================================================
NPI Number | 1073955365
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | MELISSA ANN KRINER RPH
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 07/27/2013
-----------------------------------------------------
Last Update Date | 07/27/2013
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 5900 PERKIOMEN AVE
-----------------------------------------------------
City | READING
-----------------------------------------------------
State | PA
-----------------------------------------------------
Zip | 19606-3635
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 610-582-7288
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 300 PENNS LN
-----------------------------------------------------
City | DOUGLASSVILLE
-----------------------------------------------------
State | PA
-----------------------------------------------------
Zip | 19518-8702
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 610-763-1921
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 183500000X
-----------------------------------------------------
Taxonomy Name | Pharmacist
-----------------------------------------------------
License Number | RP035273L
-----------------------------------------------------
License Number State | PA
-----------------------------------------------------