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General NPI Number Information
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NPI Number | 1760017941
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Entity Type | Individual
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Provider Name | ANNIE F MELANCON RPH
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Gender | Female
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Dates
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Enumeration Date | 03/08/2020
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Last Update Date | 03/08/2020
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Provider Practice Location Address
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Address Line | 2640 NORTH DR
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City | ABBEVILLE
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State | LA
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Zip | 70510-4043
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Country | US
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Telephone | 337-893-6304
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Fax | 337-893-6306
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Provider Business Mailing Address
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Address Line | 8402 COTEAU RD
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City | NEW IBERIA
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State | LA
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Zip | 70560-8708
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Country | US
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Telephone | 337-577-3819
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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 | 16170
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License Number State | LA
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