MEDICARE: DR. PAMELA R SMITH

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	343900000X	Non-emergency Medical Transport (VAN)	718	VA

General Provider Information

NPI Number	:	1487123162
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. PAMELA R SMITH

Provider Business Mailing Address
First Line	:	6300 DALESHIRE DR
Second Line	:
City	:	NORTH CHESTERFIELD
State	:	VA
Zip	:	23234-5618
Country	:	US
Telephone Number	:	804-306-0512
Fax Number	:

Provider Business Practice Location Address
First Line	:	6300 DALESHIRE DR
Second Line	:
City	:	NORTH CHESTERFIELD
State	:	VA
Zip	:	23234-5618
Country	:	US
Telephone Number	:	804-855-9432
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/25/2018
Last Update Date	:	11/25/2018

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Directions to “ DR. PAMELA R SMITH ” Practice Location

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