Healthcare Provider Details

I. General information

NPI: 1437795648
Provider Name (Legal Business Name): AMANDA SCHLICHENMAYER PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/22/2019
Last Update Date: 11/22/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

435 S CRYSTAL ST STE 300
BUTTE MT
59701-1506
US

IV. Provider business mailing address

108 WINDAMEER CT
BUTTE MT
59701-4464
US

V. Phone/Fax

Practice location:
  • Phone: 406-496-3600
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835P2201X
TaxonomyAmbulatory Care Pharmacist
License NumberPHA-PHA-LIC-46922
License Number StateMT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: