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General NPI Number Information
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NPI Number | 1821211343
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Entity Type | Individual
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Provider Name | AMY LYNN HAVENHILL R.PH.
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Gender | Female
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Dates
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Enumeration Date | 04/11/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 1010 60TH ST
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City | WEST DES MOINES
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State | IA
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Zip | 50266-5823
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Country | US
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Telephone | 515-440-1620
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Fax | 515-440-1872
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Provider Business Mailing Address
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Address Line | 2547 NW 159TH ST
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City | CLIVE
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State | IA
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Zip | 50325-4667
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Country | US
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Telephone | 515-987-9902
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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 | 19120
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License Number State | IA
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