Provider Demographics
NPI:1497869515
Name:MORGAN, MELODY ANN (PHARMACIST)
Entity Type:Individual
Prefix:MS
First Name:MELODY
Middle Name:ANN
Last Name:MORGAN
Suffix:
Gender:F
Credentials:PHARMACIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1013 S 10TH ST
Mailing Address - Street 2:
Mailing Address - City:COMANCHE
Mailing Address - State:OK
Mailing Address - Zip Code:73529-3042
Mailing Address - Country:US
Mailing Address - Phone:580-641-1276
Mailing Address - Fax:
Practice Address - Street 1:1013 S 10TH ST
Practice Address - Street 2:
Practice Address - City:COMANCHE
Practice Address - State:OK
Practice Address - Zip Code:73529-3042
Practice Address - Country:US
Practice Address - Phone:580-641-1276
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK10154183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist