MEDICARE: MELANIE MOORE 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	115901	MN

General Provider Information

NPI Number	:	1427811868
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MELANIE MOORE RPH

Provider Business Mailing Address
First Line	:	600 MAYWOOD AVE # CC21
Second Line	:
City	:	MANKATO
State	:	MN
Zip	:	56001-7008
Country	:	US
Telephone Number	:	507-389-2483
Fax Number	:	507-389-2206

Provider Business Practice Location Address
First Line	:	600 MAYWOOD AVE # CC21
Second Line	:
City	:	MANKATO
State	:	MN
Zip	:	56001-7008
Country	:	US
Telephone Number	:	507-389-2483
Fax Number	:	507-389-2206

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

Provider Enumeration Date	:	01/30/2024
Last Update Date	:	01/30/2024

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Directions to “ MELANIE MOORE RPH” Practice Location

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