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General NPI Number Information
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NPI Number | 1376234443
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Entity Type | Individual
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Provider Name | MELISSA PAVNICK
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Gender | Female
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Dates
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Enumeration Date | 05/18/2023
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Last Update Date | 05/18/2023
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Provider Practice Location Address
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Address Line | 24 FORT EDDY RD
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City | CONCORD
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State | NH
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Zip | 03301-7404
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Country | US
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Telephone | 603-224-7784
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Fax |
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Provider Business Mailing Address
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Address Line | 246 1ST NH TPKE
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City | NORTHWOOD
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State | NH
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Zip | 03261-3404
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Country | US
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Telephone | 603-717-8337
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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 | 183700000X
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Taxonomy Name | Pharmacy Technician
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License Number | PHT129236
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License Number State | NH
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