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NPI Code Detail

MEDICARE: AMANDA RENEE WILLIAMS PHARMD

MEDICARE: AMANDA RENEE WILLIAMS PHARMD
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
1183500000XPharmacist0202210161VA

General Provider Information

NPI Number : 1639461718
Entity Type Code : Individual
Provider Name (Legal Business Name) : AMANDA RENEE WILLIAMS PHARMD
Provider Business Mailing Address
First Line : 3333 VIRGINIA BEACH BLVD
Second Line : SUITE 101
City : VIRGINIA BEACH
State : VA
Zip : 23452-5616
Country : US
Telephone Number : 757-631-2415
Fax Number : 757-631-2428
Provider Business Practice Location Address
First Line : 3333 VIRGINIA BEACH BLVD
Second Line : SUITE 101
City : VIRGINIA BEACH
State : VA
Zip : 23452-5616
Country : US
Telephone Number : 757-631-2415
Fax Number : 757-631-2428
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/09/2011
Last Update Date : 05/09/2011

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