Provider Demographics
NPI:1992769830
Name:BABCOCK, PAMELA K (R P)
Entity type:Individual
Prefix:
First Name:PAMELA
Middle Name:K
Last Name:BABCOCK
Suffix:
Gender:F
Credentials:R P
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:811 HOWELL ST
Mailing Address - Street 2:
Mailing Address - City:OXFORD
Mailing Address - State:NE
Mailing Address - Zip Code:68967
Mailing Address - Country:US
Mailing Address - Phone:308-824-3430
Mailing Address - Fax:308-824-3429
Practice Address - Street 1:811 HOWELL STREET
Practice Address - Street 2:
Practice Address - City:OXFORD
Practice Address - State:NE
Practice Address - Zip Code:68967
Practice Address - Country:US
Practice Address - Phone:308-824-3430
Practice Address - Fax:308-824-3429
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-04-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE10870183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist