Provider Demographics
NPI:1568502854
Name:AUGUSTO, MELINDA (RPH)
Entity Type:Individual
Prefix:MS
First Name:MELINDA
Middle Name:
Last Name:AUGUSTO
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:PO BOX 4055
Mailing Address - Street 2:
Mailing Address - City:CARY
Mailing Address - State:NC
Mailing Address - Zip Code:27519-4055
Mailing Address - Country:US
Mailing Address - Phone:919-621-1569
Mailing Address - Fax:
Practice Address - Street 1:16526 NC HIGHWAY 87 W
Practice Address - Street 2:
Practice Address - City:TAR HEEL
Practice Address - State:NC
Practice Address - Zip Code:28392-8608
Practice Address - Country:US
Practice Address - Phone:910-872-5721
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-02-07
Last Update Date:2024-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC13340183500000X
SC008645183500000X
FLPS29439183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist