Healthcare Provider Details

I. General information

NPI: 1699891333
Provider Name (Legal Business Name): PAMELA NOEL JONES
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/22/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1201 S EUCLID AVE
SIOUX FALLS SD
57105-7700
US

IV. Provider business mailing address

3409 S JESSE JAMES CIR
SIOUX FALLS SD
57103-7163
US

V. Phone/Fax

Practice location:
  • Phone: 605-328-2620
  • Fax:
Mailing address:
  • Phone: 605-371-1035
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number3895
License Number StateSD
# 2
Primary TaxonomyN
Taxonomy Code183500000X
TaxonomyPharmacist
License Number117212-8
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: