Provider Demographics
NPI:1033286174
Name:PIERCE, AMIE J (RPH)
Entity Type:Individual
Prefix:
First Name:AMIE
Middle Name:J
Last Name:PIERCE
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11620 N MERIDIAN RD
Mailing Address - Street 2:
Mailing Address - City:PLEASANT LAKE
Mailing Address - State:MI
Mailing Address - Zip Code:49272-9708
Mailing Address - Country:US
Mailing Address - Phone:517-769-4802
Mailing Address - Fax:
Practice Address - Street 1:900 E GANSON ST
Practice Address - Street 2:
Practice Address - City:JACKSON
Practice Address - State:MI
Practice Address - Zip Code:49201-1700
Practice Address - Country:US
Practice Address - Phone:517-787-3194
Practice Address - Fax:517-787-8005
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5302027698183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist