Provider Demographics
NPI:1063560068
Name:MELIOR INC
Entity type:Organization
Organization Name:MELIOR INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER MGR
Authorized Official - Prefix:
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:
Authorized Official - Last Name:CHAUVIN
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:225-773-7715
Mailing Address - Street 1:PO BOX 40588
Mailing Address - Street 2:
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70835-0588
Mailing Address - Country:US
Mailing Address - Phone:225-401-4140
Mailing Address - Fax:225-401-4076
Practice Address - Street 1:58608 BELLEVIEW RD STE A
Practice Address - Street 2:
Practice Address - City:PLAQUEMINE
Practice Address - State:LA
Practice Address - Zip Code:70764-3915
Practice Address - Country:US
Practice Address - Phone:225-401-4140
Practice Address - Fax:225-401-4076
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-08
Last Update Date:2020-11-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1202801Medicaid
2029120OtherPK
LA1202801Medicaid