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General NPI Number Information
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NPI Number | 1790378198
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Entity Type | Individual
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Provider Name | AMY GOODPASTER PHARMD
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Gender | Female
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Dates
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Enumeration Date | 02/17/2021
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Last Update Date | 02/17/2021
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Provider Practice Location Address
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Address Line | 2508 MYRTLE ST
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City | ERIE
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State | PA
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Zip | 16502-2646
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Country | US
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Telephone | 814-452-5446
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Fax | 814-452-7842
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Provider Business Mailing Address
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Address Line | 6695 RICHARDSON RD
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City | FAIRVIEW
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State | PA
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Zip | 16415-1653
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Country | US
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Telephone | 407-810-3441
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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 | 1835X0200X
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Taxonomy Name | Oncology Pharmacist
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License Number | RP447002
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License Number State | PA
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