Healthcare Provider Details

I. General information

NPI: 1992194385
Provider Name (Legal Business Name): AMDAN INCORPORATED
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/22/2015
Last Update Date: 07/01/2025
Certification Date: 07/01/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9004 HAVENSIGHT SHOPP CTR SUITE D THROUGH F
ST THOMAS VI
00802-2657
US

IV. Provider business mailing address

PO BOX 600180
ST THOMAS VI
00801-6180
US

V. Phone/Fax

Practice location:
  • Phone: 340-776-1235
  • Fax: 340-776-1776
Mailing address:
  • Phone: 340-776-1235
  • Fax: 340-776-1776

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code3336L0003X
TaxonomyLong Term Care Pharmacy
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code333600000X
TaxonomyPharmacy
License Number1-30441-1L
License Number StateVI

VIII. Authorized Official

Name: AMY DURAND
Title or Position: OWNER
Credential:
Phone: 340-776-1235