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NPI Code Detail

MEDICARE: ADVANCED MEDICAL THERAPEUTICS PHARMACY

MEDICARE: ADVANCED MEDICAL THERAPEUTICS PHARMACY
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
13336C0003XCommunity/Retail Pharmacy8788NC

General Provider Information

NPI Number : 1093919151
Entity Type Code : Organization
Provider Name (Legal Business Name) : ADVANCED MEDICAL THERAPEUTICS PHARMACY
Provider Business Mailing Address
First Line : 3505 AUSTIN BLUFFS PKWY
Second Line : SUITE 101
City : COLORADO SPRINGS
State : CO
Zip : 80918-5702
Country : US
Telephone Number : 719-262-0022
Fax Number : 719-955-1490
Provider Business Practice Location Address
First Line : 4217 S NEW HOPE RD
Second Line :
City : GASTONIA
State : NC
Zip : 28056-8453
Country : US
Telephone Number : 866-828-8203
Fax Number : 704-824-1874
Authorized Official
Title or Position : PHARMACIST-IN-CHARGE
Name : MS. MELANIE GENTILE
Credential : RPH
Telephone Number : 866-828-8203
Provider Enumeration Date : 06/13/2007
Last Update Date : 01/30/2008

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Directions to “ADVANCED MEDICAL THERAPEUTICS PHARMACY ” Practice Location

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