Provider Demographics
NPI:1619667615
Name:MELA PHARMACY LLC
Entity Type:Organization
Organization Name:MELA PHARMACY LLC
Other - Org Name:MELA PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:VERSHA
Authorized Official - Middle Name:DODWANI
Authorized Official - Last Name:LOHANA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:718-674-6161
Mailing Address - Street 1:11003 101ST AVENUE
Mailing Address - Street 2:
Mailing Address - City:SOUTH RICHMOND HILL
Mailing Address - State:NY
Mailing Address - Zip Code:11419
Mailing Address - Country:US
Mailing Address - Phone:718-674-6161
Mailing Address - Fax:718-674-6464
Practice Address - Street 1:11003 101ST AVENUE
Practice Address - Street 2:
Practice Address - City:SOUTH RICHMOND HILL
Practice Address - State:NY
Practice Address - Zip Code:11419-1031
Practice Address - Country:US
Practice Address - Phone:718-674-6161
Practice Address - Fax:718-674-6464
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-05-11
Last Update Date:2023-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333600000XSuppliersPharmacy