MEDICARE: AMANDA D HAMMOCK PHARMD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	183500000X	Pharmacist	PS41223	FL

General Provider Information

NPI Number	:	1073157392
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	AMANDA D HAMMOCK PHARMD

Provider Business Mailing Address
First Line	:	12072 STONEWOOD CT
Second Line	:
City	:	JACKSONVILLE
State	:	FL
Zip	:	32223-4003
Country	:	US
Telephone Number	:	904-210-0621
Fax Number	:

Provider Business Practice Location Address
First Line	:	10550 OLD SAINT AUGUSTINE RD
Second Line	:
City	:	JACKSONVILLE
State	:	FL
Zip	:	32257-8660
Country	:	US
Telephone Number	:	904-380-8274
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/30/2019
Last Update Date	:	10/30/2019

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Directions to “ AMANDA D HAMMOCK PHARMD” Practice Location

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