Provider Demographics
NPI:1558830554
Name:MENAPACE, MELISSA ANN (RPH)
Entity Type:Individual
Prefix:
First Name:MELISSA
Middle Name:ANN
Last Name:MENAPACE
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:339 W WALNUT ST
Mailing Address - Street 2:
Mailing Address - City:SHAMOKIN
Mailing Address - State:PA
Mailing Address - Zip Code:17872-5225
Mailing Address - Country:US
Mailing Address - Phone:570-648-7669
Mailing Address - Fax:570-644-3979
Practice Address - Street 1:339 W WALNUT ST
Practice Address - Street 2:
Practice Address - City:SHAMOKIN
Practice Address - State:PA
Practice Address - Zip Code:17872-5225
Practice Address - Country:US
Practice Address - Phone:570-648-7669
Practice Address - Fax:570-644-3979
Is Sole Proprietor?:No
Enumeration Date:2018-11-19
Last Update Date:2018-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARP031154L183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist