MEDICARE: MRS. MELISSA ANN MOOK 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	RP036785L	PA

General Provider Information

NPI Number	:	1336135870
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. MELISSA ANN MOOK RPH

Provider Business Mailing Address
First Line	:	877 NIGHTLIGHT DR
Second Line	:
City	:	YORK
State	:	PA
Zip	:	17402-8810
Country	:	US
Telephone Number	:	717-600-8148
Fax Number	:	717-851-5897

Provider Business Practice Location Address
First Line	:	304 SAINT CHARLES WAY
Second Line	:
City	:	YORK
State	:	PA
Zip	:	17402-4647
Country	:	US
Telephone Number	:	717-851-5895
Fax Number	:	717-851-5897

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

Provider Enumeration Date	:	09/20/2005
Last Update Date	:	07/08/2007

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