Provider Demographics
NPI:1316295736
Name:MARTIN, PAMELA K (PHARMD, RPH)
Entity type:Individual
Prefix:DR
First Name:PAMELA
Middle Name:K
Last Name:MARTIN
Suffix:
Gender:F
Credentials:PHARMD, RPH
Other - Prefix:DR
Other - First Name:PAMELA
Other - Middle Name:M
Other - Last Name:HARDEN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:PHARMD, RPH
Mailing Address - Street 1:2605 SUNSET AVE
Mailing Address - Street 2:
Mailing Address - City:ROCKY MOUNT
Mailing Address - State:NC
Mailing Address - Zip Code:27804-3748
Mailing Address - Country:US
Mailing Address - Phone:252-443-6033
Mailing Address - Fax:252-451-7837
Practice Address - Street 1:2605 SUNSET AVE
Practice Address - Street 2:
Practice Address - City:ROCKY MOUNT
Practice Address - State:NC
Practice Address - Zip Code:27804-3748
Practice Address - Country:US
Practice Address - Phone:252-443-6033
Practice Address - Fax:252-451-7837
Is Sole Proprietor?:No
Enumeration Date:2012-08-15
Last Update Date:2012-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC21093183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist