Healthcare Provider Details

I. General information

NPI: 1720379027
Provider Name (Legal Business Name): PAMELA BOYD REEVE RPH
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/21/2011
Last Update Date: 04/21/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2714 CAHABA RD
MOUNTAIN BRK AL
35223-2304
US

IV. Provider business mailing address

2714 CAHABA RD
MOUNTAIN BRK AL
35223-2304
US

V. Phone/Fax

Practice location:
  • Phone: 205-871-1141
  • Fax: 205-871-7439
Mailing address:
  • Phone: 205-871-1141
  • Fax: 205-871-7439

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number11970
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: