Provider Demographics
NPI:1689944134
Name:BARTZ HALASCHAK, PAMALA K (RPH)
Entity Type:Individual
Prefix:MRS
First Name:PAMALA
Middle Name:K
Last Name:BARTZ HALASCHAK
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 1:2337 BUTTERFLY PALM DR.
Mailing Address - Street 2:
Mailing Address - City:NAPLES
Mailing Address - State:FL
Mailing Address - Zip Code:34119
Mailing Address - Country:US
Mailing Address - Phone:239-580-8000
Mailing Address - Fax:239-594-1139
Practice Address - Street 1:7301 RADIO RD.
Practice Address - Street 2:
Practice Address - City:NAPLES
Practice Address - State:FL
Practice Address - Zip Code:34104
Practice Address - Country:US
Practice Address - Phone:239-353-2484
Practice Address - Fax:239-353-3255
Is Sole Proprietor?:No
Enumeration Date:2011-12-30
Last Update Date:2011-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS20319183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL101188000Medicaid