MEDICARE: AMANDA DAHL 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
1	183500000X	Pharmacist	5420	SD

General Provider Information

NPI Number	:	1205350667
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	AMANDA DAHL PHARM. D

Provider Business Mailing Address
First Line	:	501 S 6TH ST
Second Line	:
City	:	HOT SPRINGS
State	:	SD
Zip	:	57747-2318
Country	:	US
Telephone Number	:	605-745-3110
Fax Number	:	605-745-7241

Provider Business Practice Location Address
First Line	:	501 S 6TH ST
Second Line	:
City	:	HOT SPRINGS
State	:	SD
Zip	:	57747-2318
Country	:	US
Telephone Number	:	605-745-3110
Fax Number	:	605-745-7241

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

Provider Enumeration Date	:	07/27/2017
Last Update Date	:	07/21/2022

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