Provider Demographics
NPI:1649384975
Name:BROTHERS, PAMELA MCDANIEL (RPH)
Entity Type:Individual
Prefix:MS
First Name:PAMELA
Middle Name:MCDANIEL
Last Name:BROTHERS
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 1:3309 COBBLESTONE CT
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27607-3120
Mailing Address - Country:US
Mailing Address - Phone:919-733-5266
Mailing Address - Fax:919-733-1544
Practice Address - Street 1:3601 MAIL SERVICE CTR
Practice Address - Street 2:
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27699-3601
Practice Address - Country:US
Practice Address - Phone:919-733-5266
Practice Address - Fax:919-733-1544
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC5408183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist