Amanda Hartlage, PHARMD

Primary specialty

Pharmacist Clinician (PhC)/ Clinical Pharmacy SpecialistTaxonomy code 1835P0018X

License

26025171A Issued in IN

Practice address

289 Ireland Ave
Fort Knox, KY 40121-5111

Phone

(812) 624-0857

NPI assigned

Dec 21, 2013

Last updated

Jun 13, 2016By the provider in NPPES

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Other names 1

• Ms. Amanda Hornback Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Pharmacy

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1387584000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1465776000000",
    "number": "1215358072",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "289 IRELAND AVE",
            "city": "FORT KNOX",
            "state": "KY",
            "postal_code": "401215111",
            "telephone_number": "502-624-0857"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "289 IRELAND AVE",
            "city": "FORT KNOX",
            "state": "KY",
            "postal_code": "401215111",
            "telephone_number": "812-624-0857"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HARTLAGE",
        "first_name": "AMANDA",
        "name_prefix": "Mrs.",
        "credential": "PHARMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-12-21",
        "last_updated": "2016-06-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "IN",
            "license": "26025171A",
            "primary": false
        },
        {
            "code": "1835P0018X",
            "taxonomy_group": "",
            "desc": "Pharmacist, Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist",
            "state": "IN",
            "license": "26025171A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "AMANDA",
            "last_name": "HORNBACK",
            "prefix": "MS.",
            "credential": "PHARMD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Seth Hall, DDS
• Jackie K Hamilton, PHARM.D.
• Rebecca Ann Hardie, ARNP,BC MSN CS
• Kirby Allen Harper, P.A.C.
• Renee Therese Hart, DNP, FNP-BC
• Stacey J Haynes, LCSW
• Stephanie Katherine Head, LMFT, LCSW
• Mary Lynne Healey, LCSW, MAC, CAS
• Matthew Halim Helmy Sr., DMD
• Kayla Henderson, APRN

• Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist in Fort Knox, KY
• Providers in Fort Knox, KY by specialty
• Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 13, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.