Provider Demographics
NPI:1083847008
Name:HANCOCK, MELANIE (PHARMD)
Entity Type:Individual
Prefix:
First Name:MELANIE
Middle Name:
Last Name:HANCOCK
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1150
Mailing Address - Street 2:
Mailing Address - City:BURGAW
Mailing Address - State:NC
Mailing Address - Zip Code:28425-1150
Mailing Address - Country:US
Mailing Address - Phone:910-259-2514
Mailing Address - Fax:910-259-5702
Practice Address - Street 1:206 US HWY 117 S
Practice Address - Street 2:
Practice Address - City:BURGAW
Practice Address - State:NC
Practice Address - Zip Code:28425
Practice Address - Country:US
Practice Address - Phone:910-259-2514
Practice Address - Fax:910-259-5702
Is Sole Proprietor?:Yes
Enumeration Date:2009-08-25
Last Update Date:2009-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC14361183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist