Provider Demographics
NPI:1790085025
Name:TODD, PAMELA ROBERSON (RPH)
Entity Type:Individual
Prefix:MRS
First Name:PAMELA
Middle Name:ROBERSON
Last Name:TODD
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 1:126 E MACON ST
Mailing Address - Street 2:
Mailing Address - City:WARRENTON
Mailing Address - State:NC
Mailing Address - Zip Code:27589-2018
Mailing Address - Country:US
Mailing Address - Phone:252-257-2922
Mailing Address - Fax:252-257-5221
Practice Address - Street 1:126 E MACON ST
Practice Address - Street 2:
Practice Address - City:WARRENTON
Practice Address - State:NC
Practice Address - Zip Code:27589-2018
Practice Address - Country:US
Practice Address - Phone:252-257-2922
Practice Address - Fax:252-257-5221
Is Sole Proprietor?:No
Enumeration Date:2010-11-03
Last Update Date:2010-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC7057183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist