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NPI Code Detail

MEDICARE: DR. AMANDA JO PERKINS PHARM D.

MEDICARE: DR. AMANDA JO PERKINS PHARM D.
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
1183500000XPharmacist118583MN

General Provider Information

NPI Number : 1144312026
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. AMANDA JO PERKINS PHARM D.
Provider Business Mailing Address
First Line : 5740 OREGON CT
Second Line :
City : CRYSTAL
State : MN
Zip : 55428-4573
Country : US
Telephone Number : 763-257-5413
Fax Number :
Provider Business Practice Location Address
First Line : 2165 WHITE BEAR AVE N
Second Line :
City : MAPLEWOOD
State : MN
Zip : 55109-2707
Country : US
Telephone Number : 612-740-6515
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/29/2006
Last Update Date : 08/26/2008

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