Provider Demographics
NPI:1023078805
Name:MORGAN, PAMELA N (RPH, CPH)
Entity type:Individual
Prefix:MS
First Name:PAMELA
Middle Name:N
Last Name:MORGAN
Suffix:
Gender:F
Credentials:RPH, CPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:702 WASCO CT
Mailing Address - Street 2:
Mailing Address - City:BRANDON
Mailing Address - State:FL
Mailing Address - Zip Code:33511-7969
Mailing Address - Country:US
Mailing Address - Phone:813-625-3986
Mailing Address - Fax:
Practice Address - Street 1:702 WASCO CT
Practice Address - Street 2:
Practice Address - City:BRANDON
Practice Address - State:FL
Practice Address - Zip Code:33511-7969
Practice Address - Country:US
Practice Address - Phone:813-625-3986
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-24
Last Update Date:2008-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL5820183500000X
FL18860183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist