Provider Demographics
NPI:1063679157
Name:SMITH, PAMELA J (PHARMD)
Entity Type:Individual
Prefix:
First Name:PAMELA
Middle Name:J
Last Name:SMITH
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 1:890 S MONACO PKWY
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80224-1569
Mailing Address - Country:US
Mailing Address - Phone:303-394-3463
Mailing Address - Fax:303-333-6873
Practice Address - Street 1:890 S MONACO PKWY
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80224-1569
Practice Address - Country:US
Practice Address - Phone:303-394-3463
Practice Address - Fax:303-333-6873
Is Sole Proprietor?:No
Enumeration Date:2008-05-17
Last Update Date:2013-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO12934183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist