Healthcare Provider Details

I. General information

NPI: 1174592489
Provider Name (Legal Business Name): AMANDA CHARLOTTE EAMIGH PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/17/2006
Last Update Date: 04/24/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 HOSPITAL AVE
DU BOIS PA
15801-1440
US

IV. Provider business mailing address

345 THOMPSON RD
WOODLAND PA
16881-7906
US

V. Phone/Fax

Practice location:
  • Phone: 814-375-3794
  • Fax:
Mailing address:
  • Phone: 814-375-3794
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberRP439414
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: