1043527294 NPI number — DR. AMANDA CLEMMONS SAVAGE PHARMD

Table of content: DR. AMANDA CLEMMONS SAVAGE PHARMD (NPI 1043527294)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1043527294 NPI number — DR. AMANDA CLEMMONS SAVAGE PHARMD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
SAVAGE
Provider First Name:
AMANDA
Provider Middle Name:
CLEMMONS
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
PHARMD
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1043527294
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
09/09/2010
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
366 RUSS AVE
Provider Second Line Business Mailing Address:
KIM'S PHARMACY
Provider Business Mailing Address City Name:
WAYNESVILLE
Provider Business Mailing Address State Name:
NC
Provider Business Mailing Address Postal Code:
28786
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
828-452-2313
Provider Business Mailing Address Fax Number:
828-452-5451

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
366 RUSS AVE
Provider Second Line Business Practice Location Address:
KIM'S PHARMACY
Provider Business Practice Location Address City Name:
WAYNESVILLE
Provider Business Practice Location Address State Name:
NC
Provider Business Practice Location Address Postal Code:
28786
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
828-452-2313
Provider Business Practice Location Address Fax Number:
828-452-5451
Provider Enumeration Date:
09/09/2010

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 183500000X , with the licence number:  16802 , registered in the state of NC ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





Copyright © 2007-2025 www.npivalidator.com