Provider Demographics
NPI:1013926419
Name:SALASEK, PAMELA SUE (RPH)
Entity Type:Individual
Prefix:
First Name:PAMELA
Middle Name:SUE
Last Name:SALASEK
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:PAMELA
Other - Middle Name:SUE
Other - Last Name:MOSLEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RPH
Mailing Address - Street 1:4372 MUIRFIELD WAY
Mailing Address - Street 2:
Mailing Address - City:WESTLAKE
Mailing Address - State:OH
Mailing Address - Zip Code:44145-5089
Mailing Address - Country:US
Mailing Address - Phone:440-835-3690
Mailing Address - Fax:
Practice Address - Street 1:14600 DETROIT AVE
Practice Address - Street 2:
Practice Address - City:LAKEWOOD
Practice Address - State:OH
Practice Address - Zip Code:44107-4207
Practice Address - Country:US
Practice Address - Phone:216-228-4544
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH03-1-14737183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist