Provider Demographics
NPI:1750567814
Name:ADRIENNE MELGARY
Entity type:Organization
Organization Name:ADRIENNE MELGARY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OPTOMETRIST
Authorized Official - Prefix:
Authorized Official - First Name:ADRIENNE
Authorized Official - Middle Name:
Authorized Official - Last Name:MELGARY
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:304-737-3440
Mailing Address - Street 1:99 7TH ST
Mailing Address - Street 2:
Mailing Address - City:WELLSBURG
Mailing Address - State:WV
Mailing Address - Zip Code:26070-1656
Mailing Address - Country:US
Mailing Address - Phone:304-737-3440
Mailing Address - Fax:304-737-4042
Practice Address - Street 1:99 7TH ST
Practice Address - Street 2:
Practice Address - City:WELLSBURG
Practice Address - State:WV
Practice Address - Zip Code:26070-1656
Practice Address - Country:US
Practice Address - Phone:304-737-3440
Practice Address - Fax:304-737-4042
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-01-18
Last Update Date:2013-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV768-OD152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WV0150841000Medicaid
0323110001Medicare NSC