Provider Demographics
NPI:1992754071
Name:STITH, PAMELA A (RPH)
Entity type:Individual
Prefix:MRS
First Name:PAMELA
Middle Name:A
Last Name:STITH
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 1:530 SILVERBROOK DR
Mailing Address - Street 2:
Mailing Address - City:DANVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40422-1076
Mailing Address - Country:US
Mailing Address - Phone:859-238-9355
Mailing Address - Fax:859-734-3353
Practice Address - Street 1:900 S COLLEGE ST
Practice Address - Street 2:
Practice Address - City:HARRODSBURG
Practice Address - State:KY
Practice Address - Zip Code:40330-2167
Practice Address - Country:US
Practice Address - Phone:859-734-3319
Practice Address - Fax:859-734-3353
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY011477183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist