Healthcare Provider Details

I. General information

NPI: 1649520149
Provider Name (Legal Business Name): AMAL KUZMAR
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/12/2012
Last Update Date: 09/12/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

210 INGLES PL
SENECA SC
29678-0847
US

IV. Provider business mailing address

210 INGLES PL
SENECA SC
29678-0847
US

V. Phone/Fax

Practice location:
  • Phone: 864-882-6706
  • Fax: 864-886-9833
Mailing address:
  • Phone: 864-882-6706
  • Fax: 864-886-9833

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number11127
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: