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General NPI Number Information
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NPI Number | 1396031522
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Entity Type | Individual
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Provider Name | AMANDA A OMAN PHARM. D.
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Gender | Female
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Dates
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Enumeration Date | 06/27/2011
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Last Update Date | 06/27/2011
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Provider Practice Location Address
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Address Line | 1447 E 7TH ST
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City | MONTICELLO
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State | MN
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Zip | 55362-4666
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Country | US
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Telephone | 763-271-1101
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Fax |
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Provider Business Mailing Address
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Address Line | 1020 OAK LN
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City | MONTICELLO
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State | MN
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Zip | 55362-8999
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Country | US
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Telephone |
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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 | 119055
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License Number State | MN
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