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General NPI Number Information
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NPI Number | 1801358999
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Entity Type | Individual
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Provider Name | AMANDA LYNN MERRY PHARM D
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Gender | Female
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Dates
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Enumeration Date | 04/05/2019
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Last Update Date | 04/05/2019
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Provider Practice Location Address
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Address Line | 23148 HIGHWAY 5
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City | CENTERVILLE
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State | IA
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Zip | 52544-8421
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Country | US
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Telephone | 641-437-7185
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Fax | 641-856-0505
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Provider Business Mailing Address
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Address Line | 20005 205TH AVE
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City | CENTERVILLE
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State | IA
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Zip | 52544-8939
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Country | US
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Telephone | 641-856-3551
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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 | 20600
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License Number State | IA
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