Healthcare Provider Details

I. General information

NPI: 1477424109
Provider Name (Legal Business Name): AMBER TOLER PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/16/2025
Last Update Date: 07/14/2026
Certification Date: 07/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7251 INTERSTATE DR
HORN LAKE MS
38637-1410
US

IV. Provider business mailing address

7251 INTERSTATE DR
HORN LAKE MS
38637-1410
US

V. Phone/Fax

Practice location:
  • Phone: 662-349-8336
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1835P0018X
TaxonomyPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
License Number49227
License Number StateTN
# 2
Primary TaxonomyN
Taxonomy Code1835P0018X
TaxonomyPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
License NumberE102135
License Number StateMS
# 3
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberE-102135
License Number StateMS
# 4
Primary TaxonomyN
Taxonomy Code183500000X
TaxonomyPharmacist
License Number49227
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: