Melanie Beedle, RPH
Individual provider Active NPI Pharmacist · Normal, IL
NPI 1194173740 · NPPES record last updated May 24, 2016
Key facts
- NPI
- 1194173740
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pharmacist 183500000X
- License
- 051292192 (IL)
- Practice address
- 901 S Cottage Ave
Normal, IL 61761-3302 - Phone
- (309) 454-8768
- NPI assigned
- May 24, 2016
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- Credentials
- Registered Pharmacist
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 051292192 | IL | MD | Pharmacist |
| 28906 | TX | MD | Pharmacist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 051292192 | IL | Yes |
| Pharmacist | 183500000X | 28906 | TX |
Addresses
Primary practice location
901 S Cottage Ave
Normal, IL 61761-3302
Mailing address
901 S Cottage Ave
Normal, IL 61761-3302
Phone (309) 454-8768
Other providers in Normal, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 24, 2016. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.