Provider Demographics
NPI:1205128758
Name:HALL, PAMELA L (PHARMD)
Entity type:Individual
Prefix:MS
First Name:PAMELA
Middle Name:L
Last Name:HALL
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 1:472 COUNTRY RUN CIR
Mailing Address - Street 2:
Mailing Address - City:POWELL
Mailing Address - State:TN
Mailing Address - Zip Code:37849-5428
Mailing Address - Country:US
Mailing Address - Phone:865-947-4618
Mailing Address - Fax:
Practice Address - Street 1:308 S ILLINOIS AVE
Practice Address - Street 2:
Practice Address - City:OAK RIDGE
Practice Address - State:TN
Practice Address - Zip Code:37830-6740
Practice Address - Country:US
Practice Address - Phone:865-483-3301
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-05-03
Last Update Date:2011-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN81901835P1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P1200XPharmacy Service ProvidersPharmacistPharmacotherapy
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN8190OtherPHARMACIST LICENSE