Provider Demographics
NPI:1831404870
Name:DUPLECHAIN-CELLUM, PAMELA (DOCTOR OF PHARMACY)
Entity type:Individual
Prefix:
First Name:PAMELA
Middle Name:
Last Name:DUPLECHAIN-CELLUM
Suffix:
Gender:F
Credentials:DOCTOR OF PHARMACY
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1106 N MARTIN LUTHER KING HWY
Mailing Address - Street 2:
Mailing Address - City:LAKE CHARLES
Mailing Address - State:LA
Mailing Address - Zip Code:70601-2048
Mailing Address - Country:US
Mailing Address - Phone:337-436-7833
Mailing Address - Fax:337-436-1119
Practice Address - Street 1:1106 N MARTIN LUTHER KING HWY
Practice Address - Street 2:
Practice Address - City:LAKE CHARLES
Practice Address - State:LA
Practice Address - Zip Code:70601-2048
Practice Address - Country:US
Practice Address - Phone:337-436-7833
Practice Address - Fax:337-436-1119
Is Sole Proprietor?:No
Enumeration Date:2010-08-14
Last Update Date:2010-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA16234183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist