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General NPI Number Information
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NPI Number | 1750921821
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Entity Type | Individual
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Provider Name | MELISSA JO FIALA PHARM. D.
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Gender | Female
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Dates
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Enumeration Date | 01/07/2020
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Last Update Date | 01/07/2020
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Provider Practice Location Address
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Address Line | 8170 DOUGLAS AVE
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City | URBANDALE
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State | IA
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Zip | 50322-2411
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Country | US
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Telephone | 515-276-3471
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Fax |
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Provider Business Mailing Address
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Address Line | 4520 160TH ST
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City | URBANDALE
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State | IA
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Zip | 50323-2281
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Country | US
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Telephone | 515-559-7174
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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 | 19041
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License Number State | IA
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