Provider Demographics
NPI:1992869762
Name:MAURATH, MELANY ANN (RPH)
Entity type:Individual
Prefix:
First Name:MELANY
Middle Name:ANN
Last Name:MAURATH
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 1:3511 CEDAR CRST
Mailing Address - Street 2:
Mailing Address - City:OAKLEY
Mailing Address - State:KS
Mailing Address - Zip Code:67748-6011
Mailing Address - Country:US
Mailing Address - Phone:785-672-3421
Mailing Address - Fax:
Practice Address - Street 1:211 CHERRY AVE
Practice Address - Street 2:
Practice Address - City:OAKLEY
Practice Address - State:KS
Practice Address - Zip Code:67748-1201
Practice Address - Country:US
Practice Address - Phone:785-672-3211
Practice Address - Fax:785-672-8184
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS11097183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist