Provider Demographics
NPI:1285956789
Name:YBEMA, MELINDA BETH (RPH)
Entity type:Individual
Prefix:
First Name:MELINDA
Middle Name:BETH
Last Name:YBEMA
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:599 GENEVA ST.
Mailing Address - Street 2:
Mailing Address - City:ST. CATHARINES
Mailing Address - State:ONTARIO
Mailing Address - Zip Code:L2N 2J3
Mailing Address - Country:CA
Mailing Address - Phone:905-935-1607
Mailing Address - Fax:
Practice Address - Street 1:5535 PORTER RD
Practice Address - Street 2:
Practice Address - City:NIAGARA FALLS
Practice Address - State:NY
Practice Address - Zip Code:14304-1521
Practice Address - Country:US
Practice Address - Phone:716-298-5120
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-02-24
Last Update Date:2010-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY047796183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist