Basic Information
| Provider Information | |||||||||
| NPI: | 1790382794 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | MELLO | ||||||||
| FirstName: | RONALD | ||||||||
| MiddleName: | MICHAEL | ||||||||
| NamePrefix: | MR. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 325 ASBURY RD | ||||||||
| Address2: | |||||||||
| City: | CANDLER | ||||||||
| State: | NC | ||||||||
| PostalCode: | 287159671 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8287753357 | ||||||||
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| Practice Location | |||||||||
| Address1: | 1100 TUNNEL RD | ||||||||
| Address2: | |||||||||
| City: | ASHEVILLE | ||||||||
| State: | NC | ||||||||
| PostalCode: | 288052576 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8282987911 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 10/03/2020 | ||||||||
| LastUpdateDate: | 10/03/2020 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 10/03/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 183700000X | 43025 | NC | Y | Pharmacy Service Providers | Pharmacy Technician |
No ID Information.