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NPI Code Detail

MEDICARE: AMANDA JILL SMITH RPH

MEDICARE:   AMANDA JILL SMITH  RPH
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
1183500000XPharmacistRP 5957WV

General Provider Information

NPI Number : 1467854802
Entity Type Code : Individual
Provider Name (Legal Business Name) : AMANDA JILL SMITH RPH
Provider Business Mailing Address
First Line : 341 SHAFFERS RUN RD
Second Line :
City : MILL CREEK
State : WV
Zip : 26280-4527
Country : US
Telephone Number : 304-940-0414
Fax Number :
Provider Business Practice Location Address
First Line : 8591 HOLLY MEADOWS RD
Second Line :
City : PARSONS
State : WV
Zip : 26287-8604
Country : US
Telephone Number : 304-478-3339
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/17/2014
Last Update Date : 02/10/2022

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Directions to “ AMANDA JILL SMITH RPH” Practice Location

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