Provider Demographics
NPI:1013423185
Name:PALERMO, PAMELA ANN (RPH)
Entity Type:Individual
Prefix:
First Name:PAMELA
Middle Name:ANN
Last Name:PALERMO
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 1:200 SOCIAL ST
Mailing Address - Street 2:
Mailing Address - City:WOONSOCKET
Mailing Address - State:RI
Mailing Address - Zip Code:02895-2058
Mailing Address - Country:US
Mailing Address - Phone:401-762-9200
Mailing Address - Fax:
Practice Address - Street 1:200 SOCIAL ST
Practice Address - Street 2:
Practice Address - City:WOONSOCKET
Practice Address - State:RI
Practice Address - Zip Code:02895-2058
Practice Address - Country:US
Practice Address - Phone:401-762-9200
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-12-27
Last Update Date:2017-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RI03379183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist