Provider Demographics
NPI:1164721494
Name:TODD, PAMALA FRANCIS (DPH)
Entity Type:Individual
Prefix:
First Name:PAMALA
Middle Name:FRANCIS
Last Name:TODD
Suffix:
Gender:F
Credentials:DPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5561 BROWNS MILL RD
Mailing Address - Street 2:
Mailing Address - City:LASCASSAS
Mailing Address - State:TN
Mailing Address - Zip Code:37085-4627
Mailing Address - Country:US
Mailing Address - Phone:615-890-6707
Mailing Address - Fax:
Practice Address - Street 1:1622 MIDDLE TENNESSEE BLVD
Practice Address - Street 2:
Practice Address - City:MURFREESBORO
Practice Address - State:TN
Practice Address - Zip Code:37130-5108
Practice Address - Country:US
Practice Address - Phone:615-896-3327
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-03-25
Last Update Date:2011-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN6314183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist