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General NPI Number Information
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NPI Number | 1124678271
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Entity Type | Individual
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Provider Name | AMANDA MARIE MCGEHEE PHARM. D.
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Gender | Female
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Dates
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Enumeration Date | 09/19/2019
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Last Update Date | 11/11/2021
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Provider Practice Location Address
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Address Line | 523 THAIN RD
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City | LEWISTON
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State | ID
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Zip | 83501-5530
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Country | US
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Telephone | 208-743-5515
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Fax |
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Provider Business Mailing Address
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Address Line | 1031 DIAMOND DR
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City | LEWISTON
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State | ID
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Zip | 83501-9413
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Country | US
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Telephone | 208-848-6174
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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 | P8523
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License Number State | ID
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Taxonomy #2
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | PH60960349
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License Number State | WA
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