Provider Demographics
NPI:1851673057
Name:MCALLISTER, PAMELA ANN (RPH)
Entity Type:Individual
Prefix:
First Name:PAMELA
Middle Name:ANN
Last Name:MCALLISTER
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 1:104 N MAIN ST
Mailing Address - Street 2:
Mailing Address - City:VERONA
Mailing Address - State:WI
Mailing Address - Zip Code:53593-1160
Mailing Address - Country:US
Mailing Address - Phone:608-848-7154
Mailing Address - Fax:608-848-7168
Practice Address - Street 1:104 N MAIN ST
Practice Address - Street 2:
Practice Address - City:VERONA
Practice Address - State:WI
Practice Address - Zip Code:53593-1160
Practice Address - Country:US
Practice Address - Phone:608-848-7154
Practice Address - Fax:608-848-7168
Is Sole Proprietor?:No
Enumeration Date:2011-09-13
Last Update Date:2011-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI9372183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist