Provider Demographics
NPI:1346322849
Name:MASON, TAMARA ELIZABETH (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:TAMARA
Middle Name:ELIZABETH
Last Name:MASON
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:8129 S FORDNEY RD
Mailing Address - Street 2:
Mailing Address - City:SAINT CHARLES
Mailing Address - State:MI
Mailing Address - Zip Code:48655-9762
Mailing Address - Country:US
Mailing Address - Phone:989-323-1873
Mailing Address - Fax:000-000-0000
Practice Address - Street 1:1522 JANES AVE
Practice Address - Street 2:
Practice Address - City:SAGINAW
Practice Address - State:MI
Practice Address - Zip Code:48601-1819
Practice Address - Country:US
Practice Address - Phone:989-755-3633
Practice Address - Fax:989-755-3614
Is Sole Proprietor?:No
Enumeration Date:2006-10-20
Last Update Date:2018-10-25
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MI5302033019183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist