MEDICARE: AMANDA DRYMALSKI 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	116993	MN
2	183500000X	Pharmacist	5646	SD
3	183500000X	Pharmacist	2012033847	MO

General Provider Information

NPI Number	:	1255843413
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	AMANDA DRYMALSKI PHARM.D

Provider Business Mailing Address
First Line	:	911 E. ROLLINS ST. RM. 1207
Second Line	:	MIZZOU PHARMACY
City	:	COLUMBIA
State	:	MO
Zip	:	65201
Country	:	US
Telephone Number	:	573-884-4373
Fax Number	:	573-882-4843

Provider Business Practice Location Address
First Line	:	911 E. ROLLINS ST. RM. 1207
Second Line	:	MIZZOU PHARMACY
City	:	COLUMBIA
State	:	MO
Zip	:	65201-5738
Country	:	US
Telephone Number	:	573-884-4373
Fax Number	:	573-882-4843

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

Provider Enumeration Date	:	10/27/2017
Last Update Date	:	10/27/2017

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