Provider Demographics
NPI:1932489671
Name:OSTERHAUS, PAMELA MARIE (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:PAMELA
Middle Name:MARIE
Last Name:OSTERHAUS
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:105 E 6TH ST
Mailing Address - Street 2:
Mailing Address - City:CARROLL
Mailing Address - State:IA
Mailing Address - Zip Code:51401-2418
Mailing Address - Country:US
Mailing Address - Phone:712-792-4012
Mailing Address - Fax:
Practice Address - Street 1:105 E 6TH ST
Practice Address - Street 2:
Practice Address - City:CARROLL
Practice Address - State:IA
Practice Address - Zip Code:51401-2418
Practice Address - Country:US
Practice Address - Phone:712-792-4012
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-08-25
Last Update Date:2011-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA19056183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist