Provider Demographics
NPI:1346840139
Name:VARNADORE, MELANIE BROOKE (PHARMD, RPH)
Entity Type:Individual
Prefix:DR
First Name:MELANIE
Middle Name:BROOKE
Last Name:VARNADORE
Suffix:
Gender:F
Credentials:PHARMD, RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:174 ANDREA ST
Mailing Address - Street 2:
Mailing Address - City:BAXLEY
Mailing Address - State:GA
Mailing Address - Zip Code:31513-7139
Mailing Address - Country:US
Mailing Address - Phone:912-253-6108
Mailing Address - Fax:
Practice Address - Street 1:136 E JARMAN ST
Practice Address - Street 2:
Practice Address - City:HAZLEHURST
Practice Address - State:GA
Practice Address - Zip Code:31539-6130
Practice Address - Country:US
Practice Address - Phone:912-375-3646
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-10-29
Last Update Date:2020-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARPH031055183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist