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NPI Code Detail

MEDICARE: MEL PHARM INC.

MEDICARE: MEL PHARM INC.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1332B00000XDurable Medical Equipment & Medical Supplies
2333600000XPharmacy
33336C0003XCommunity/Retail PharmacyPHY53630CA
43336C0003XCommunity/Retail Pharmacy

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1PHY75698OTHERCAPHARMACY LICENSE
21999775OTHERPK
3MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1104821776
Entity Type Code : Organization
Provider Name (Legal Business Name) : MEL PHARM INC.
Provider Business Mailing Address
First Line : 402 S. MADERA AVE STE A
Second Line :
City : MADERA
State : CA
Zip : 93637-3203
Country : US
Telephone Number : 559-674-8553
Fax Number : 559-674-0947
Provider Business Practice Location Address
First Line : 402 S. MADERA AVE STE A
Second Line :
City : MADERA
State : CA
Zip : 93637-3203
Country : US
Telephone Number : 559-674-8553
Fax Number : 559-674-0947
Authorized Official
Title or Position : OWNER/PRESIDENT
Name : MR. SIRTAJ SINGH
Credential : PHARMD
Telephone Number : 559-674-8553
Provider Enumeration Date : 06/20/2005
Last Update Date : 01/30/2020

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