Provider Demographics
NPI:1205184835
Name:SOMMER, AMANDA KAY (PHARMD)
Entity Type:Individual
Prefix:
First Name:AMANDA
Middle Name:KAY
Last Name:SOMMER
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3752 FAIRWAY PARK DR
Mailing Address - Street 2:APT 206
Mailing Address - City:COPLEY
Mailing Address - State:OH
Mailing Address - Zip Code:44321-3105
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:3129 LINCOLN WAY E
Practice Address - Street 2:
Practice Address - City:MASSILLON
Practice Address - State:OH
Practice Address - Zip Code:44646-3756
Practice Address - Country:US
Practice Address - Phone:330-837-3138
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-08-29
Last Update Date:2012-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHRPH 03132261183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist