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General NPI Number Information
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NPI Number | 1861929713
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Entity Type | Individual
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Provider Name | MELINDA CORLEY RPH
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Gender | Female
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Dates
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Enumeration Date | 05/22/2017
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Last Update Date | 05/22/2017
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Provider Practice Location Address
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Address Line | 10 BARNES WEST DR
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City | CREVE COEUR
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State | MO
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Zip | 63141-6350
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Country | US
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Telephone | 314-996-3403
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Fax |
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Provider Business Mailing Address
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Address Line | 10 BARNES WEST DR
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City | CREVE COEUR
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State | MO
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Zip | 63141-6350
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Country | US
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Telephone | 314-996-3403
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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 | 1835X0200X
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Taxonomy Name | Oncology Pharmacist
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License Number | 2009023429
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License Number State | MO
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