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General NPI Number Information
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NPI Number | 1205125689
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Entity Type | Individual
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Provider Name | MRS. MELANIE MURPHREE MASSENGILL
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Gender | Female
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Dates
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Enumeration Date | 04/06/2011
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Last Update Date | 04/06/2011
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Provider Practice Location Address
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Address Line | 205 STATE HIGHWAY 30 W
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City | NEW ALBANY
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State | MS
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Zip | 38652-3111
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Country | US
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Telephone | 662-534-8181
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Fax | 662-534-6255
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Provider Business Mailing Address
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Address Line | 1090 COUNTY ROAD 64 N
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City | NEW ALBANY
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State | MS
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Zip | 38652-8916
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Country | US
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Telephone | 662-538-0769
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | E08821
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License Number State | MS
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