Provider Demographics
NPI:1578832747
Name:MELTON, EMILY LANELL (PHARMD)
Entity Type:Individual
Prefix:
First Name:EMILY
Middle Name:LANELL
Last Name:MELTON
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 1:1000 HUGH WARD BLVD
Mailing Address - Street 2:
Mailing Address - City:FLOWOOD
Mailing Address - State:MS
Mailing Address - Zip Code:39232-6600
Mailing Address - Country:US
Mailing Address - Phone:019-923-4266
Mailing Address - Fax:601-992-6871
Practice Address - Street 1:1000 HUGH WARD BLVD
Practice Address - Street 2:
Practice Address - City:FLOWOOD
Practice Address - State:MS
Practice Address - Zip Code:39232
Practice Address - Country:US
Practice Address - Phone:019-923-4266
Practice Address - Fax:601-992-6871
Is Sole Proprietor?:No
Enumeration Date:2011-12-18
Last Update Date:2018-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC23032183500000X
MSE12554183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist