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NPI Code Detail

MEDICARE: DR. MELISSA TYSON BRIDGES PHARMD

MEDICARE: DR. MELISSA TYSON BRIDGES PHARMD
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
1183500000XPharmacist14341NC

General Provider Information

NPI Number : 1124353453
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. MELISSA TYSON BRIDGES PHARMD
Provider Business Mailing Address
First Line : 2314 TROOPER LN
Second Line :
City : NASHVILLE
State : NC
Zip : 27856-7820
Country : US
Telephone Number : 252-212-0381
Fax Number : 252-212-8138
Provider Business Practice Location Address
First Line : 1590 BENVENUE RD
Second Line :
City : ROCKY MOUNT
State : NC
Zip : 27804-6342
Country : US
Telephone Number : 252-212-0381
Fax Number : 252-212-8138
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/05/2009
Last Update Date : 10/05/2009

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Directions to “ DR. MELISSA TYSON BRIDGES PHARMD” Practice Location

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