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General NPI Number Information
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NPI Number | 1063710168
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Entity Type | Individual
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Provider Name | PAMELA BAZEMORE SHIPPY PHARM.D.
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Gender | Female
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Dates
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Enumeration Date | 03/14/2011
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Last Update Date | 03/14/2011
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Provider Practice Location Address
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Address Line | 780 CHURCH ST NE
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City | MARIETTA
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State | GA
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Zip | 30060-7269
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Country | US
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Telephone | 770-422-5821
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Fax | 770-428-4425
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Provider Business Mailing Address
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Address Line | 780 CHURCH ST NE
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City | MARIETTA
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State | GA
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Zip | 30060-7269
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Country | US
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Telephone | 770-422-5821
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Fax | 770-428-4425
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | RPH020174
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License Number State | GA
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