Provider Demographics
NPI:1144920109
Name:BELCHER, MELONY ANN (REGISTERED PHARMACY)
Entity type:Individual
Prefix:
First Name:MELONY
Middle Name:ANN
Last Name:BELCHER
Suffix:
Gender:F
Credentials:REGISTERED PHARMACY
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1175 LOUSIANNA AVE.
Mailing Address - Street 2:
Mailing Address - City:PERRYSBURG
Mailing Address - State:OH
Mailing Address - Zip Code:43551
Mailing Address - Country:US
Mailing Address - Phone:419-874-3485
Mailing Address - Fax:
Practice Address - Street 1:1175 LOUISIANA AVE
Practice Address - Street 2:
Practice Address - City:PERRYSBURG
Practice Address - State:OH
Practice Address - Zip Code:43551-2537
Practice Address - Country:US
Practice Address - Phone:419-874-3458
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-03-08
Last Update Date:2023-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH09216398183700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183700000XPharmacy Service ProvidersPharmacy Technician