Provider Demographics
NPI:1497480958
Name:THOMAS, MELANY (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:MELANY
Middle Name:
Last Name:THOMAS
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 1:1766 BELLA TERRA DR
Mailing Address - Street 2:
Mailing Address - City:MANTECA
Mailing Address - State:CA
Mailing Address - Zip Code:95337-8238
Mailing Address - Country:US
Mailing Address - Phone:209-679-0961
Mailing Address - Fax:
Practice Address - Street 1:1766 BELLA TERRA DR
Practice Address - Street 2:
Practice Address - City:MANTECA
Practice Address - State:CA
Practice Address - Zip Code:95337-8238
Practice Address - Country:US
Practice Address - Phone:209-679-0961
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-07-19
Last Update Date:2022-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA85615183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist