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General NPI Number Information
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NPI Number | 1194320622
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Entity Type | Individual
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Provider Name | AMY GUARD PHARMD
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Gender | Female
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Dates
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Enumeration Date | 12/02/2020
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Last Update Date | 12/02/2020
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Provider Practice Location Address
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Address Line | 601 S KINGS DR STE Q
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City | CHARLOTTE
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State | NC
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Zip | 28204-3074
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Country | US
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Telephone | 704-333-7435
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Fax | 704-371-6985
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Provider Business Mailing Address
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Address Line | 601 S KINGS DR STE Q
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City | CHARLOTTE
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State | NC
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Zip | 28204-3074
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Country | US
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Telephone | 704-333-7345
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Fax | 704-371-6985
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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 | 16908
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License Number State | NC
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