Provider Demographics
NPI:1326313982
Name:WOLFSON, PAMELA ANN (RPH)
Entity Type:Individual
Prefix:
First Name:PAMELA
Middle Name:ANN
Last Name:WOLFSON
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 1:4212 E SUNRISE DR
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85044-1012
Mailing Address - Country:US
Mailing Address - Phone:602-369-7404
Mailing Address - Fax:866-801-9912
Practice Address - Street 1:4212 E SUNRISE DR
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85044-1012
Practice Address - Country:US
Practice Address - Phone:602-369-7404
Practice Address - Fax:866-801-9912
Is Sole Proprietor?:Yes
Enumeration Date:2012-03-15
Last Update Date:2012-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ0100101835P0018X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P0018XPharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist