Provider Demographics
NPI:1174126502
Name:ALDERMAN, MELINDA SANDERS (PHARMD)
Entity type:Individual
Prefix:
First Name:MELINDA
Middle Name:SANDERS
Last Name:ALDERMAN
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5698 COUNTY ROAD 183
Mailing Address - Street 2:
Mailing Address - City:GREENWOOD
Mailing Address - State:MS
Mailing Address - Zip Code:38930-6879
Mailing Address - Country:US
Mailing Address - Phone:662-299-4408
Mailing Address - Fax:662-299-4408
Practice Address - Street 1:2202 HIGHWAY 82 WEST
Practice Address - Street 2:
Practice Address - City:GREENWOOD
Practice Address - State:MS
Practice Address - Zip Code:38930
Practice Address - Country:US
Practice Address - Phone:662-455-8240
Practice Address - Fax:662-455-8240
Is Sole Proprietor?:Yes
Enumeration Date:2020-11-18
Last Update Date:2020-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MSE-09348183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist