Provider Demographics
NPI:1942441555
Name:REEDER, PAMELA SUE (RPH)
Entity Type:Individual
Prefix:
First Name:PAMELA
Middle Name:SUE
Last Name:REEDER
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 1:7321 BALMER ST
Mailing Address - Street 2:BLDG. 570
Mailing Address - City:HILL AFB
Mailing Address - State:UT
Mailing Address - Zip Code:84056-5012
Mailing Address - Country:US
Mailing Address - Phone:801-777-5463
Mailing Address - Fax:801-586-9890
Practice Address - Street 1:7321 BALMER ST
Practice Address - Street 2:BLDG. 570
Practice Address - City:HILL AFB
Practice Address - State:UT
Practice Address - Zip Code:84056-5012
Practice Address - Country:US
Practice Address - Phone:801-777-5463
Practice Address - Fax:801-586-9890
Is Sole Proprietor?:No
Enumeration Date:2009-03-11
Last Update Date:2009-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT151044-1701183500000X
NE9829183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist