Amy Janette Maxberry, PHARM.D.
Individual provider Active NPI Pharmacist · Lake Station, IN
NPI 1366670663 · NPPES record last updated Jun 24, 2009
Key facts
- NPI
- 1366670663
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pharmacist 183500000X
- License
- 26023163A (IN)
- Practice address
- 2490 Central Ave
Lake Station, IN 46405-2122 - Phone
- (219) 962-5909
- Fax
- (219) 962-5981
- NPI assigned
- Jun 24, 2009
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- Credentials
- Doctor of Pharmacy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 26023163A | IN | MD | Pharmacist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 26023163A | IN | Yes |
Addresses
Primary practice location
2490 Central Ave
Lake Station, IN 46405-2122
Mailing address
4512 W 73Rd CT
Merrillville, IN 46410-7333
Phone (219) 791-0622
Other providers in Lake Station, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 24, 2009. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.