MEDICARE: AMAH OLUFUMILAYO HAMILTON

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	PS50921	FL

General Provider Information

NPI Number	:	1538551767
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	AMAH OLUFUMILAYO HAMILTON

Provider Business Mailing Address
First Line	:	11 UNIVERSITY BLVD N
Second Line	:
City	:	JACKSONVILLE
State	:	FL
Zip	:	32211-7550
Country	:	US
Telephone Number	:	904-727-9939
Fax Number	:

Provider Business Practice Location Address
First Line	:	11 UNIVERSITY BLVD N
Second Line	:
City	:	JACKSONVILLE
State	:	FL
Zip	:	32211-7550
Country	:	US
Telephone Number	:	904-727-9939
Fax Number	:

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

Provider Enumeration Date	:	02/25/2015
Last Update Date	:	02/25/2015

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