Provider Demographics
NPI:1215206743
Name:CHAMBERS, MELDA (RPH)
Entity Type:Individual
Prefix:
First Name:MELDA
Middle Name:
Last Name:CHAMBERS
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:PO BOX 2996
Mailing Address - Street 2:
Mailing Address - City:UPPER MARLBORO
Mailing Address - State:MD
Mailing Address - Zip Code:20773-2996
Mailing Address - Country:US
Mailing Address - Phone:202-422-8694
Mailing Address - Fax:
Practice Address - Street 1:9960 MAYLAND DR STE 300
Practice Address - Street 2:
Practice Address - City:HENRICO
Practice Address - State:VA
Practice Address - Zip Code:23233-1485
Practice Address - Country:US
Practice Address - Phone:202-422-8694
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-12-29
Last Update Date:2012-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0202012467183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist