Provider Demographics
NPI:1447340708
Name:HORTON, MELANIE SCOTTON (PHARMD)
Entity type:Individual
Prefix:DR
First Name:MELANIE
Middle Name:SCOTTON
Last Name:HORTON
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 1:1114 SIMPSON ST
Mailing Address - Street 2:
Mailing Address - City:EDEN
Mailing Address - State:NC
Mailing Address - Zip Code:27288-6349
Mailing Address - Country:US
Mailing Address - Phone:336-627-4914
Mailing Address - Fax:
Practice Address - Street 1:109 S VAN BUREN RD
Practice Address - Street 2:
Practice Address - City:EDEN
Practice Address - State:NC
Practice Address - Zip Code:27288-5026
Practice Address - Country:US
Practice Address - Phone:336-623-9026
Practice Address - Fax:336-623-9052
Is Sole Proprietor?:No
Enumeration Date:2006-10-14
Last Update Date:2022-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC11773183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC0795302Medicaid