Healthcare Provider Details

I. General information

NPI: 1851668479
Provider Name (Legal Business Name): AMANDA KOBYLINSKI PHARM.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/28/2011
Last Update Date: 09/26/2024
Certification Date: 09/26/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

640 S STATE ST
DOVER DE
19901-3530
US

IV. Provider business mailing address

1000 SUN CIR UNIT 107
DOVER DE
19904-8020
US

V. Phone/Fax

Practice location:
  • Phone: 304-744-6615
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code183500000X
TaxonomyPharmacist
License Number03331043-3
License Number StateOH
# 2
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberA1-0016011
License Number StateDE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: