Provider Demographics
NPI:1760655963
Name:WELCH, PAMELA S (RPH)
Entity Type:Individual
Prefix:
First Name:PAMELA
Middle Name:S
Last Name:WELCH
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 1:216 BRAMBLE CT
Mailing Address - Street 2:
Mailing Address - City:WILLIAMSVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:14221-1715
Mailing Address - Country:US
Mailing Address - Phone:716-688-5064
Mailing Address - Fax:
Practice Address - Street 1:5783 S TRANSIT RD
Practice Address - Street 2:
Practice Address - City:LOCKPORT
Practice Address - State:NY
Practice Address - Zip Code:14094-5811
Practice Address - Country:US
Practice Address - Phone:716-438-2748
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-04-08
Last Update Date:2008-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY035960-1183500000X
WVRP0003543183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist