MEDICARE: MELISSA ANNE TRUESDELL RPH

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
1	183500000X	Pharmacist	RP036825L	PA

General Provider Information

NPI Number	:	1265032130
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MELISSA ANNE TRUESDELL RPH

Provider Business Mailing Address
First Line	:	2685 TIMBERGLEN DR
Second Line	:
City	:	WEXFORD
State	:	PA
Zip	:	15090-7562
Country	:	US
Telephone Number	:	724-594-7479
Fax Number	:	724-247-1733

Provider Business Practice Location Address
First Line	:	2000 VILLAGE CENTER DR
Second Line	:
City	:	TARENTUM
State	:	PA
Zip	:	15084-3844
Country	:	US
Telephone Number	:	724-274-1730
Fax Number	:	724-274-1733

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/29/2020
Last Update Date	:	10/29/2020

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