Provider Demographics
NPI:1922363647
Name:MCANINCH, MELANIE K (PHARMD)
Entity Type:Individual
Prefix:
First Name:MELANIE
Middle Name:K
Last Name:MCANINCH
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 1:122 GAYOSO AVE
Mailing Address - Street 2:APT 209
Mailing Address - City:MEMPHIS
Mailing Address - State:TN
Mailing Address - Zip Code:38103-2958
Mailing Address - Country:US
Mailing Address - Phone:901-603-6596
Mailing Address - Fax:
Practice Address - Street 1:325 NEW BYHALIA RD
Practice Address - Street 2:
Practice Address - City:COLLIERVILLE
Practice Address - State:TN
Practice Address - Zip Code:38017-3705
Practice Address - Country:US
Practice Address - Phone:901-860-0000
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-07-09
Last Update Date:2012-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MSE-12614183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist