MEDICARE: DR. AMANDA RACHEL GIVENS 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	2009020930	MO

General Provider Information

NPI Number	:	1639453491
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. AMANDA RACHEL GIVENS PHARM.D.

Provider Business Mailing Address
First Line	:	1 EXPRESS WAY
Second Line	:
City	:	SAINT LOUIS
State	:	MO
Zip	:	63121-1824
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1 EXPRESS WAY
Second Line	:
City	:	SAINT LOUIS
State	:	MO
Zip	:	63121-1824
Country	:	US
Telephone Number	:	314-684-6996
Fax Number	:

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

Provider Enumeration Date	:	09/28/2011
Last Update Date	:	04/17/2014

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