Provider Demographics
NPI:1083943740
Name:GILLESPIE ANDERSON, MELISSA (RPH)
Entity Type:Individual
Prefix:MRS
First Name:MELISSA
Middle Name:
Last Name:GILLESPIE ANDERSON
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:235 TIMBER CREEK DR
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:MS
Mailing Address - Zip Code:39702-8028
Mailing Address - Country:US
Mailing Address - Phone:662-240-8900
Mailing Address - Fax:866-876-8966
Practice Address - Street 1:2102 5TH ST N STE 3
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:MS
Practice Address - Zip Code:39705-2222
Practice Address - Country:US
Practice Address - Phone:662-240-8900
Practice Address - Fax:866-306-8900
Is Sole Proprietor?:No
Enumeration Date:2009-12-09
Last Update Date:2009-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MSE-8357183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist