Healthcare Provider Details

I. General information

NPI: 1356731459
Provider Name (Legal Business Name): AMANDA HOWARD-THOMPSON PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/27/2015
Last Update Date: 01/27/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1301 PRIMACY PKWY
MEMPHIS TN
38119-0213
US

IV. Provider business mailing address

6072 WINDSOR OAK DR
ARLINGTON TN
38002-6805
US

V. Phone/Fax

Practice location:
  • Phone: 901-448-0255
  • Fax:
Mailing address:
  • Phone: 901-218-1510
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number23967
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: