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General NPI Number Information
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NPI Number | 1215528187
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Entity Type | Individual
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Provider Name | AMANDA LEE FARMER
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Gender | Female
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Dates
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Enumeration Date | 02/02/2021
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Last Update Date | 02/02/2021
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Provider Practice Location Address
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Address Line | 1918 W FABYAN PKWY
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City | BATAVIA
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State | IL
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Zip | 60510-1215
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Country | US
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Telephone | 630-482-2485
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Fax |
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Provider Business Mailing Address
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Address Line | 1222 JENNY DR APT G
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City | SYCAMORE
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State | IL
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Zip | 60178-9596
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Country | US
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Telephone | 630-317-4192
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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 | 183700000X
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Taxonomy Name | Pharmacy Technician
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License Number | 10100711
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License Number State | IL
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