Provider Demographics
NPI:1881765634
Name:ESTES, PAMELA S (CPHT)
Entity type:Individual
Prefix:
First Name:PAMELA
Middle Name:S
Last Name:ESTES
Suffix:
Gender:F
Credentials:CPHT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:201 ARROWWOOD DR
Mailing Address - Street 2:
Mailing Address - City:CULLODEN
Mailing Address - State:WV
Mailing Address - Zip Code:25510-9655
Mailing Address - Country:US
Mailing Address - Phone:304-634-2360
Mailing Address - Fax:
Practice Address - Street 1:208 ROXALANA BUSINESS PARK
Practice Address - Street 2:
Practice Address - City:DUNBAR
Practice Address - State:WV
Practice Address - Zip Code:25064-2727
Practice Address - Country:US
Practice Address - Phone:304-720-6970
Practice Address - Fax:304-720-6963
Is Sole Proprietor?:No
Enumeration Date:2006-11-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WVPT0001066183700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183700000XPharmacy Service ProvidersPharmacy Technician