Provider Demographics
NPI:1356467286
Name:LAFAVE, MELINDA (PHARM D)
Entity Type:Individual
Prefix:DR
First Name:MELINDA
Middle Name:
Last Name:LAFAVE
Suffix:
Gender:F
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:608 SADDLE ROCK RD
Mailing Address - Street 2:
Mailing Address - City:VIRGINIA BEACH
Mailing Address - State:VA
Mailing Address - Zip Code:23452-2951
Mailing Address - Country:US
Mailing Address - Phone:757-679-2448
Mailing Address - Fax:
Practice Address - Street 1:3653 VIRGINIA BEACH BLVD
Practice Address - Street 2:
Practice Address - City:VIRGINIA BEACH
Practice Address - State:VA
Practice Address - Zip Code:23452-3418
Practice Address - Country:US
Practice Address - Phone:757-463-2011
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0202207140183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist