Provider Demographics
NPI:1972052256
Name:TONGA, MELEANE
Entity Type:Individual
Prefix:
First Name:MELEANE
Middle Name:
Last Name:TONGA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8322 PINEVILLE MATTHEWS RD STE 601
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28226-4707
Mailing Address - Country:US
Mailing Address - Phone:704-496-5227
Mailing Address - Fax:
Practice Address - Street 1:8322 PINEVILLE MATTHEWS RD STE 601
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28226-4707
Practice Address - Country:US
Practice Address - Phone:704-496-5227
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-09-27
Last Update Date:2016-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC26454183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist