Melodie Grady, PHARMD

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

P7306 Issued in ID

Practice address

2132 W Pullman Rd
Moscow, ID 83843-4011

Phone

(208) 997-5082

Fax

(208) 207-2917

NPI assigned

Apr 15, 2015

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Pharmacy

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Idaho CVS Pharmacy LLC

  • Pharmacy
  • Lewiston, ID
  • NPI 1982626891
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1429056000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1650585600000",
    "number": "1861889990",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1143 BEAR CREEK RD",
            "city": "PRINCETON",
            "state": "ID",
            "postal_code": "838579753",
            "telephone_number": "208-874-2176"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2132 W PULLMAN RD",
            "city": "MOSCOW",
            "state": "ID",
            "postal_code": "838434011",
            "telephone_number": "208-997-5082",
            "fax_number": "208-207-2917"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1143 Bear Creek Rd",
            "address_purpose": "LOCATION",
            "city": "Princeton",
            "state": "ID",
            "postal_code": "838579753",
            "country_code": "US",
            "telephone_number": "208-874-2176",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GRADY",
        "first_name": "MELODIE",
        "credential": "PHARMD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-04-15",
        "last_updated": "2022-04-22",
        "certification_date": "2022-04-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "ID",
            "license": "E17480",
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "ID",
            "license": "P7306",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Oswaldo Gomez
• Orlando Gonzalez Gomar
• Rebecca Marie Goodrich, LMP, NCTMB
• Wendy Monique Goodrich, PA C
• Michelle Lynn Gorton, CST
• Lorraine Windridge Granfield, CRNA
• Philip Allan Gray
• Brookeanne Gregory
• Eric McLain Griffin
• Angela Griner

• Community/Retail Pharmacy in Moscow, ID
• Providers in Moscow, ID by specialty
• Community/Retail Pharmacy in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 22, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.