MEDICARE: AMY RAE CREA 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	RP046206	PA

General Provider Information

NPI Number	:	1548273816
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	AMY RAE CREA PHARM.D.

Provider Business Mailing Address
First Line	:	100 MORNING MIST DR
Second Line	:
City	:	ALIQUIPPA
State	:	PA
Zip	:	15001-1490
Country	:	US
Telephone Number	:	724-774-2617
Fax Number	:

Provider Business Practice Location Address
First Line	:	3211 4TH AVE
Second Line	:
City	:	BEAVER FALLS
State	:	PA
Zip	:	15010-3501
Country	:	US
Telephone Number	:	724-846-1784
Fax Number	:

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

Provider Enumeration Date	:	08/15/2006
Last Update Date	:	07/08/2007

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