Provider Demographics
NPI:1174666457
Name:MELS PHARMACY
Entity Type:Organization
Organization Name:MELS PHARMACY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:CURLEE
Authorized Official - Middle Name:MELVIN
Authorized Official - Last Name:FRENCH
Authorized Official - Suffix:
Authorized Official - Credentials:PD
Authorized Official - Phone:318-387-6725
Mailing Address - Street 1:1734 S 9TH ST
Mailing Address - Street 2:
Mailing Address - City:MONROE
Mailing Address - State:LA
Mailing Address - Zip Code:71202-3526
Mailing Address - Country:US
Mailing Address - Phone:318-387-6725
Mailing Address - Fax:318-387-6723
Practice Address - Street 1:1734 S 9TH ST
Practice Address - Street 2:
Practice Address - City:MONROE
Practice Address - State:LA
Practice Address - Zip Code:71202-3526
Practice Address - Country:US
Practice Address - Phone:318-387-6725
Practice Address - Fax:318-387-6723
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-15
Last Update Date:2008-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA10869183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes183500000XPharmacy Service ProvidersPharmacistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1257494Medicaid