Provider Demographics
NPI:1689275422
Name:LOPES, PAMELA-JO AMBROSE (RPH)
Entity Type:Individual
Prefix:
First Name:PAMELA-JO
Middle Name:AMBROSE
Last Name:LOPES
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 1:128 MORGEN DR
Mailing Address - Street 2:
Mailing Address - City:AUBURN
Mailing Address - State:NH
Mailing Address - Zip Code:03032-3941
Mailing Address - Country:US
Mailing Address - Phone:603-483-5613
Mailing Address - Fax:
Practice Address - Street 1:2 FREETOWN RD
Practice Address - Street 2:
Practice Address - City:RAYMOND
Practice Address - State:NH
Practice Address - Zip Code:03077-2342
Practice Address - Country:US
Practice Address - Phone:603-895-0011
Practice Address - Fax:603-895-1218
Is Sole Proprietor?:Yes
Enumeration Date:2020-11-06
Last Update Date:2020-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH2454183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist