NPI 1013117860

Gordon Riley Melvin, RPH

Practitioner Pharmacist Meridian, ID

Practice location

Address: 1570 E Fairview Ave, Meridian, ID 83642-1821
Phone: (208) 888-0034

Registered specialties

Pharmacist Primary

Pharmacy Service Providers Taxonomy 183500000X Licence P3657 (ID)

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Registry record

NPI: 1013117860
Entity type: Individual
Sex (as registered): Male
NPI issued: 20 Jul 2007
Record last updated: 20 Jul 2007

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.