Healthcare Provider Details

I. General information

NPI: 1346918356
Provider Name (Legal Business Name): AMANDA GUFFEY PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/03/2021
Last Update Date: 09/03/2021
Certification Date: 09/03/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2720 SUNSET BLVD
WEST COLUMBIA SC
29169-4810
US

IV. Provider business mailing address

612 MELTON ST
WEST COLUMBIA SC
29170-2937
US

V. Phone/Fax

Practice location:
  • Phone: 803-935-8639
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835C0205X
TaxonomyCritical Care Pharmacist
License Number13332
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: