Amanda Johnson Whitaker
Individual provider Active NPI Pharmacist · Chesnee, SC
NPI 1629326665 · NPPES record last updated Aug 23, 2012
Key facts
- NPI
- 1629326665
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pharmacist 183500000X
- License
- 7581 (SC)
- Practice address
- 109 W Manning St
Chesnee, SC 29323-1538 - Phone
- (864) 461-3123
- Fax
- (864) 703-2943
- NPI assigned
- Aug 23, 2012
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 7581 | SC | MD | Pharmacist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 7581 | SC | Yes |
Addresses
Primary practice location
109 W Manning St
Chesnee, SC 29323-1538
Mailing address
109 W Manning St
Chesnee, SC 29323-1538
Phone (864) 461-3123
Other providers in Chesnee, SC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 23, 2012. 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.