MEDICARE: DR. AMY B WERREMEYER 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
1	183500000X	Pharmacist	5020	ND
2	1835P1300X	Psychiatric Pharmacist	5020	ND

General Provider Information

NPI Number	:	1982867842
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. AMY B WERREMEYER PHARMD

Provider Business Mailing Address
First Line	:	118H SUDRO HALL
Second Line	:	NORTH DAKOTA STATE UNIVERSITY
City	:	FARGO
State	:	ND
Zip	:	58105
Country	:	US
Telephone Number	:	701-231-7603
Fax Number	:

Provider Business Practice Location Address
First Line	:	118H SUDRO HALL
Second Line	:	NORTH DAKOTA STATE UNIVERSITY
City	:	FARGO
State	:	ND
Zip	:	58105
Country	:	US
Telephone Number	:	701-231-7603
Fax Number	:

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

Provider Enumeration Date	:	07/09/2008
Last Update Date	:	07/09/2008

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