Provider Demographics
NPI:1770793978
Name:MELLACE, FRANK A JR (RPH)
Entity type:Individual
Prefix:
First Name:FRANK
Middle Name:A
Last Name:MELLACE
Suffix:JR
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:160 SUNDAY DR
Mailing Address - Street 2:
Mailing Address - City:STATE COLLEGE
Mailing Address - State:PA
Mailing Address - Zip Code:16801-2554
Mailing Address - Country:US
Mailing Address - Phone:814-571-4456
Mailing Address - Fax:
Practice Address - Street 1:68 SPRING ST
Practice Address - Street 2:
Practice Address - City:LOCK HAVEN
Practice Address - State:PA
Practice Address - Zip Code:17745-1911
Practice Address - Country:US
Practice Address - Phone:570-263-5830
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-23
Last Update Date:2024-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARP039292T183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist