Provider Demographics
NPI:1922216399
Name:O'FERRALL, MELISSA MORGAN (RPH)
Entity Type:Individual
Prefix:MRS
First Name:MELISSA
Middle Name:MORGAN
Last Name:O'FERRALL
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 1:173 GATEWAY DR
Mailing Address - Street 2:
Mailing Address - City:ROCKY FACE
Mailing Address - State:GA
Mailing Address - Zip Code:30740-8946
Mailing Address - Country:US
Mailing Address - Phone:706-226-0098
Mailing Address - Fax:
Practice Address - Street 1:1710 CLEVELAND HWY
Practice Address - Street 2:
Practice Address - City:DALTON
Practice Address - State:GA
Practice Address - Zip Code:30721-8313
Practice Address - Country:US
Practice Address - Phone:706-259-9787
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARPH017771183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist