Provider Demographics
NPI:1093962797
Name:SIMONS, MELINDA L (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:MELINDA
Middle Name:L
Last Name:SIMONS
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:DR
Other - First Name:MELINDA
Other - Middle Name:L
Other - Last Name:DAVIS
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:1821 HILLANDALE RD
Mailing Address - Street 2:KERR DRUG 408
Mailing Address - City:DURHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27705-2659
Mailing Address - Country:US
Mailing Address - Phone:919-383-0820
Mailing Address - Fax:919-382-7467
Practice Address - Street 1:1821 HILLANDALE RD
Practice Address - Street 2:KERR DRUG 408
Practice Address - City:DURHAM
Practice Address - State:NC
Practice Address - Zip Code:27705-2659
Practice Address - Country:US
Practice Address - Phone:919-383-0820
Practice Address - Fax:919-382-7467
Is Sole Proprietor?:No
Enumeration Date:2008-08-25
Last Update Date:2008-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC15587183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist