Healthcare Provider Details

I. General information

NPI: 1942441555
Provider Name (Legal Business Name): PAMELA SUE REEDER R.PH.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/11/2009
Last Update Date: 03/11/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7321 BALMER ST BLDG. 570
HILL AFB UT
84056-5012
US

IV. Provider business mailing address

7321 BALMER ST BLDG. 570
HILL AFB UT
84056-5012
US

V. Phone/Fax

Practice location:
  • Phone: 801-777-5463
  • Fax: 801-586-9890
Mailing address:
  • Phone: 801-777-5463
  • Fax: 801-586-9890

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number151044-1701
License Number StateUT
# 2
Primary TaxonomyN
Taxonomy Code183500000X
TaxonomyPharmacist
License Number9829
License Number StateNE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: