MEDICARE: AMANDA SIEGLE 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
1	183500000X	Pharmacist	22316	IA

General Provider Information

NPI Number	:	1851790281
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	AMANDA SIEGLE PHARMD

Provider Business Mailing Address
First Line	:	2503 5TH AVE S
Second Line	:
City	:	FORT DODGE
State	:	IA
Zip	:	50501-5552
Country	:	US
Telephone Number	:	515-576-7113
Fax Number	:	515-576-5782

Provider Business Practice Location Address
First Line	:	2503 5TH AVE S
Second Line	:
City	:	FORT DODGE
State	:	IA
Zip	:	50501-5552
Country	:	US
Telephone Number	:	515-576-7113
Fax Number	:	515-576-5782

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

Provider Enumeration Date	:	08/21/2014
Last Update Date	:	08/21/2014

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Directions to “ AMANDA SIEGLE PHARMD” Practice Location

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