MEDICARE: DR. AMY VREUGDENHIL TUCKER PHARM.D.

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	183500000X	Pharmacist	15534	NC

General Provider Information

NPI Number	:	1164404406
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. AMY VREUGDENHIL TUCKER PHARM.D.

Provider Business Mailing Address
First Line	:	10 PITTS SCHOOL RD NW
Second Line	:
City	:	CONCORD
State	:	NC
Zip	:	28027-0302
Country	:	US
Telephone Number	:	704-795-0051
Fax Number	:

Provider Business Practice Location Address
First Line	:	10 PITTS SCHOOL RD NW
Second Line	:
City	:	CONCORD
State	:	NC
Zip	:	28027-0302
Country	:	US
Telephone Number	:	704-795-0051
Fax Number	:

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

Provider Enumeration Date	:	11/14/2005
Last Update Date	:	03/24/2008

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