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NPI Code Detail

MEDICARE: AMANDA WILLIAMS

MEDICARE: AMANDA WILLIAMS
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
1183500000XPharmacist26025244AIN

General Provider Information

NPI Number : 1487086278
Entity Type Code : Individual
Provider Name (Legal Business Name) : AMANDA WILLIAMS
Provider Business Mailing Address
First Line : 6536 CARROLLTON AVE
Second Line : APT 48
City : INDIANAPOLIS
State : IN
Zip : 46220-1637
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 3003 N KESSLER BLVD DR
Second Line :
City : INDIANAPOLIS
State : IN
Zip : 46222-1990
Country : US
Telephone Number : 317-925-3788
Fax Number : 317-926-1898
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/02/2013
Last Update Date : 08/02/2013

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Directions to “ AMANDA WILLIAMS ” Practice Location

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