Provider Demographics
NPI:1902823446
Name:HILLS, MELISSA SUE (RPH)
Entity Type:Individual
Prefix:MRS
First Name:MELISSA
Middle Name:SUE
Last Name:HILLS
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 1:3573 E 28TH STREET
Mailing Address - Street 2:
Mailing Address - City:WHITE CLOUD
Mailing Address - State:MI
Mailing Address - Zip Code:49349
Mailing Address - Country:US
Mailing Address - Phone:231-689-6392
Mailing Address - Fax:
Practice Address - Street 1:6 S MAIN ST
Practice Address - Street 2:GRICES PHARMACY
Practice Address - City:KENT CITY
Practice Address - State:MI
Practice Address - Zip Code:49330
Practice Address - Country:US
Practice Address - Phone:616-678-5380
Practice Address - Fax:616-678-9911
Is Sole Proprietor?:No
Enumeration Date:2006-07-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5302030546183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist