MEDICARE: MELISSA MARIE PUCCINI 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	1835P2201X	Ambulatory Care Pharmacist	03215233	OH

General Provider Information

NPI Number	:	1942966148
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MELISSA MARIE PUCCINI RPH

Provider Business Mailing Address
First Line	:	2794 REDWING CT
Second Line	:
City	:	HAMILTON
State	:	OH
Zip	:	45013-8518
Country	:	US
Telephone Number	:	513-505-2545
Fax Number	:

Provider Business Practice Location Address
First Line	:	7567 BRIDGETOWN RD
Second Line	:
City	:	CINCINNATI
State	:	OH
Zip	:	45248-2051
Country	:	US
Telephone Number	:	513-941-4011
Fax Number	:	513-941-4016

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

Provider Enumeration Date	:	11/11/2021
Last Update Date	:	11/11/2021

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