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NPI Code Detail

MEDICARE: AMANI ENGELHARDT

MEDICARE: AMANI ENGELHARDT
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
1183500000XPharmacist033313593OH

General Provider Information

NPI Number : 1437432093
Entity Type Code : Individual
Provider Name (Legal Business Name) : AMANI ENGELHARDT
Provider Business Mailing Address
First Line : 1380 LEXINGTON AVE
Second Line :
City : MANSFIELD
State : OH
Zip : 44907-2616
Country : US
Telephone Number : 419-756-2609
Fax Number :
Provider Business Practice Location Address
First Line : 1380 LEXINGTON AVE
Second Line :
City : MANSFIELD
State : OH
Zip : 44907-2616
Country : US
Telephone Number : 419-756-2609
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/21/2011
Last Update Date : 09/21/2011

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Directions to “ AMANI ENGELHARDT ” Practice Location

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