Provider Demographics
NPI:1073572889
Name:JONES, PAMELA LYNN (PHARMD)
Entity Type:Individual
Prefix:
First Name:PAMELA
Middle Name:LYNN
Last Name:JONES
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:PAMELA
Other - Middle Name:LYNN
Other - Last Name:MOSS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PHARMD
Mailing Address - Street 1:15150 NAUGHTON DR
Mailing Address - Street 2:
Mailing Address - City:SOUTH HOLLAND
Mailing Address - State:IL
Mailing Address - Zip Code:60473-1163
Mailing Address - Country:US
Mailing Address - Phone:708-331-1619
Mailing Address - Fax:
Practice Address - Street 1:ROBBINS HEALTH CENTER
Practice Address - Street 2:13450 SOUTH KEDZIE
Practice Address - City:ROBBINS
Practice Address - State:IL
Practice Address - Zip Code:60472
Practice Address - Country:US
Practice Address - Phone:708-293-8100
Practice Address - Fax:708-293-8120
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-03-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL51287636183500000X
CA49044183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist