Provider Demographics
NPI:1265032130
Name:TRUESDELL, MELISSA ANNE (RPH)
Entity Type:Individual
Prefix:
First Name:MELISSA
Middle Name:ANNE
Last Name:TRUESDELL
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 1:2685 TIMBERGLEN DR
Mailing Address - Street 2:
Mailing Address - City:WEXFORD
Mailing Address - State:PA
Mailing Address - Zip Code:15090-7562
Mailing Address - Country:US
Mailing Address - Phone:724-594-7479
Mailing Address - Fax:724-247-1733
Practice Address - Street 1:2000 VILLAGE CENTER DR
Practice Address - Street 2:
Practice Address - City:TARENTUM
Practice Address - State:PA
Practice Address - Zip Code:15084-3844
Practice Address - Country:US
Practice Address - Phone:724-274-1730
Practice Address - Fax:724-274-1733
Is Sole Proprietor?:No
Enumeration Date:2020-10-29
Last Update Date:2020-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARP036825L183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist