Healthcare Provider Details

I. General information

NPI: 1770564023
Provider Name (Legal Business Name): AMY B PERRY PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 11/11/2005
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

639 W MAIN ST
BARNESVILLE OH
43713-1039
US

IV. Provider business mailing address

319 JOHNET DR APT 7
SAINT CLAIRSVILLE OH
43950-1028
US

V. Phone/Fax

Practice location:
  • Phone: 740-425-5108
  • Fax:
Mailing address:
  • Phone: 740-695-5676
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number03-3-25769
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: