Provider Demographics
NPI:1093083115
Name:JONES, MELINDA KAY (RPH)
Entity Type:Individual
Prefix:
First Name:MELINDA
Middle Name:KAY
Last Name:JONES
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 1:433 CEDAR ST
Mailing Address - Street 2:
Mailing Address - City:PETAL
Mailing Address - State:MS
Mailing Address - Zip Code:39465-4436
Mailing Address - Country:US
Mailing Address - Phone:601-447-6567
Mailing Address - Fax:
Practice Address - Street 1:509 HIGHWAY 589
Practice Address - Street 2:
Practice Address - City:PURVIS
Practice Address - State:MS
Practice Address - Zip Code:39475-4114
Practice Address - Country:US
Practice Address - Phone:601-794-2583
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-12-03
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MSE-08763183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist