Provider Demographics
NPI:1083043764
Name:BRAMLETT, PAMELA (RPH)
Entity Type:Individual
Prefix:
First Name:PAMELA
Middle Name:
Last Name:BRAMLETT
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 1:115 PELHAM RD
Mailing Address - Street 2:STE 12
Mailing Address - City:GREENVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29615-2184
Mailing Address - Country:US
Mailing Address - Phone:864-558-0507
Mailing Address - Fax:
Practice Address - Street 1:115 PELHAM RD
Practice Address - Street 2:STE 12
Practice Address - City:GREENVILLE
Practice Address - State:SC
Practice Address - Zip Code:29615-2184
Practice Address - Country:US
Practice Address - Phone:864-558-0507
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-11-04
Last Update Date:2013-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC13167183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC13167OtherPHARMACY LICENSE