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NPI Code Detail

MEDICARE: AMANDA MARIE KREBS PHARMD

MEDICARE: AMANDA MARIE KREBS 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
1183500000XPharmacistPS57964FL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1PS57964OTHERFLPHARMACIST LICENSE NUMBER
203337158OTHEROHPHARMACIST LICENSE NUMBER

General Provider Information

NPI Number : 1255810545
Entity Type Code : Individual
Provider Name (Legal Business Name) : AMANDA MARIE KREBS PHARMD
Provider Business Mailing Address
First Line : 1312 LODGE TER
Second Line :
City : DELTONA
State : FL
Zip : 32738-9729
Country : US
Telephone Number : 513-373-1651
Fax Number :
Provider Business Practice Location Address
First Line : 605 COURTLAND BLVD
Second Line :
City : DELTONA
State : FL
Zip : 32738-8913
Country : US
Telephone Number : 407-321-5421
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/08/2018
Last Update Date : 08/08/2018

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