Provider Demographics
NPI:1932519220
Name:PAMULA, BARRY LEE (RPH)
Entity Type:Individual
Prefix:
First Name:BARRY
Middle Name:LEE
Last Name:PAMULA
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:86 MEADOW LN
Mailing Address - Street 2:
Mailing Address - City:PENINSULA
Mailing Address - State:OH
Mailing Address - Zip Code:44264-9714
Mailing Address - Country:US
Mailing Address - Phone:330-322-2880
Mailing Address - Fax:
Practice Address - Street 1:86 MEADOW LN
Practice Address - Street 2:
Practice Address - City:PENINSULA
Practice Address - State:OH
Practice Address - Zip Code:44264-9714
Practice Address - Country:US
Practice Address - Phone:330-322-2880
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-05-07
Last Update Date:2014-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH03318297183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist