Provider Demographics
NPI:1891941340
Name:HOPPERS, PAMELA MOXLEY (RPH)
Entity Type:Individual
Prefix:MRS
First Name:PAMELA
Middle Name:MOXLEY
Last Name:HOPPERS
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 1:5152 HIGHWAY 18 SOUTH
Mailing Address - Street 2:
Mailing Address - City:SPARTA
Mailing Address - State:NC
Mailing Address - Zip Code:28675
Mailing Address - Country:US
Mailing Address - Phone:336-372-2101
Mailing Address - Fax:336-372-7661
Practice Address - Street 1:454 S MAIN ST
Practice Address - Street 2:
Practice Address - City:SPARTA
Practice Address - State:NC
Practice Address - Zip Code:28675-9606
Practice Address - Country:US
Practice Address - Phone:336-372-2101
Practice Address - Fax:336-372-7661
Is Sole Proprietor?:No
Enumeration Date:2008-08-15
Last Update Date:2008-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC11364183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist