MEDICARE: AMANDA WILLIAMS 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	0202219279	VA

General Provider Information

NPI Number	:	1891403747
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	AMANDA WILLIAMS PHARMD

Provider Business Mailing Address
First Line	:	100 CHESTNUT CT
Second Line	:
City	:	YORKTOWN
State	:	VA
Zip	:	23692-3051
Country	:	US
Telephone Number	:	937-605-2136
Fax Number	:

Provider Business Practice Location Address
First Line	:	7529 RICHMOND RD
Second Line	:
City	:	WILLIAMSBURG
State	:	VA
Zip	:	23188-7226
Country	:	US
Telephone Number	:	757-259-7892
Fax Number	:

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

Provider Enumeration Date	:	11/09/2022
Last Update Date	:	11/09/2022

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