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General NPI Number Information
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NPI Number | 1730939406
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Entity Type | Individual
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Provider Name | CHRISTIAN STEPHEN D'AMBROSIO PHARMD
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Gender | Male
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Dates
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Enumeration Date | 03/25/2024
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Last Update Date | 03/25/2024
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Provider Practice Location Address
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Address Line | 2301 E MARKLAND AVE
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City | KOKOMO
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State | IN
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Zip | 46901-6245
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Country | US
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Telephone | 765-454-7810
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Fax | 765-454-7865
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Provider Business Mailing Address
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Address Line | 324 UXBRIDGE LN
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City | CARMEL
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State | IN
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Zip | 46032-4587
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Country | US
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Telephone | 585-474-5318
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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 | 26030606A
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License Number State | IN
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