Provider Demographics
NPI:1528207909
Name:DICKSON, MELODY ELIZABETH (PHARM D)
Entity Type:Individual
Prefix:
First Name:MELODY
Middle Name:ELIZABETH
Last Name:DICKSON
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 1:2935 E RIGGS RD
Mailing Address - Street 2:
Mailing Address - City:CHANDLER
Mailing Address - State:AZ
Mailing Address - Zip Code:85249-3671
Mailing Address - Country:US
Mailing Address - Phone:480-802-1980
Mailing Address - Fax:480-802-1967
Practice Address - Street 1:2935 E RIGGS RD
Practice Address - Street 2:
Practice Address - City:CHANDLER
Practice Address - State:AZ
Practice Address - Zip Code:85249-3671
Practice Address - Country:US
Practice Address - Phone:480-802-1980
Practice Address - Fax:480-802-1967
Is Sole Proprietor?:Yes
Enumeration Date:2009-02-09
Last Update Date:2009-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZS012960183500000X
RIRPH04256183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist