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General NPI Number Information
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NPI Number | 1104306380
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Entity Type | Individual
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Provider Name | SAMANTHA DAWN GOLDEN PHARMD
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Gender | Female
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Dates
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Enumeration Date | 08/17/2018
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Last Update Date | 08/17/2018
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Provider Practice Location Address
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Address Line | 100 S LEAVITT RD
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City | AMHERST
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State | OH
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Zip | 44001-1780
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Country | US
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Telephone | 440-988-5832
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Fax |
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Provider Business Mailing Address
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Address Line | 51428 STATE ROUTE 113
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City | AMHERST
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State | OH
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Zip | 44001-9404
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Country | US
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Telephone | 440-541-6704
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 03337578
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License Number State | OH
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