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General NPI Number Information
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NPI Number | 1851601934
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Entity Type | Individual
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Provider Name | MELISSA F WILMOTH RPH
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Gender | Female
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Dates
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Enumeration Date | 10/07/2010
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Last Update Date | 10/07/2010
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Provider Practice Location Address
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Address Line | 122 HILLCREST PKWY
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City | DUBLIN
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State | GA
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Zip | 31021-6340
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Country | US
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Telephone | 478-296-1773
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Fax | 478-296-1448
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Provider Business Mailing Address
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Address Line | 3211 MASON LN
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City | DUBLIN
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State | GA
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Zip | 31021-0337
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Country | US
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Telephone | 478-278-0243
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Fax | 478-296-1448
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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 | 17977
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License Number State | GA
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