Provider Demographics
NPI:1205312022
Name:REESE, PAMELA CESARE (RPH)
Entity type:Individual
Prefix:
First Name:PAMELA
Middle Name:CESARE
Last Name:REESE
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 1:1930 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:SANFORD
Mailing Address - State:ME
Mailing Address - Zip Code:04073-4479
Mailing Address - Country:US
Mailing Address - Phone:207-490-2069
Mailing Address - Fax:207-490-2096
Practice Address - Street 1:1930 MAIN ST
Practice Address - Street 2:
Practice Address - City:SANFORD
Practice Address - State:ME
Practice Address - Zip Code:04073-4479
Practice Address - Country:US
Practice Address - Phone:207-490-2069
Practice Address - Fax:207-490-2096
Is Sole Proprietor?:No
Enumeration Date:2018-07-15
Last Update Date:2018-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MEPR5309183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist