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General NPI Number Information
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NPI Number | 1811264617
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Entity Type | Individual
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Provider Name | AMANDA DUDICS R.PH.
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Gender | Female
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Dates
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Enumeration Date | 11/22/2011
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Last Update Date | 11/17/2020
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Provider Practice Location Address
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Address Line | 7415 OLD TROY PIKE
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City | HUBER HEIGHTS
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State | OH
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Zip | 45424-2662
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Country | US
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Telephone | 937-723-2880
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Fax |
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Provider Business Mailing Address
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Address Line | 1297 BEECH TRL
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City | DAYTON
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State | OH
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Zip | 45458-4768
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Country | US
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Telephone | 419-348-9874
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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 | 03331147
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License Number State | OH
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Taxonomy #2
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | RPH.03331147-3
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License Number State | OH
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