Provider Demographics
NPI:1386188324
Name:RICHMOND, MELANIE (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:MELANIE
Middle Name:
Last Name:RICHMOND
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2963 PENNSYLVANIA AVE
Mailing Address - Street 2:
Mailing Address - City:CHARLESTON
Mailing Address - State:WV
Mailing Address - Zip Code:25302-4577
Mailing Address - Country:US
Mailing Address - Phone:276-623-3994
Mailing Address - Fax:
Practice Address - Street 1:2963 PENNSYLVANIA AVE
Practice Address - Street 2:APARTMENT 7
Practice Address - City:CHARLESTON
Practice Address - State:WV
Practice Address - Zip Code:25302-4577
Practice Address - Country:US
Practice Address - Phone:276-623-3994
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-12-09
Last Update Date:2016-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH03136281183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist