Provider Demographics
NPI:1275827545
Name:KING, AMBER (PHARMD)
Entity Type:Individual
Prefix:
First Name:AMBER
Middle Name:
Last Name:KING
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 1:1800 VALLEY WEST DR
Mailing Address - Street 2:T-0069
Mailing Address - City:WEST DES MOINES
Mailing Address - State:IA
Mailing Address - Zip Code:50266-1104
Mailing Address - Country:US
Mailing Address - Phone:515-225-3170
Mailing Address - Fax:515-802-3360
Practice Address - Street 1:1800 VALLEY WEST DR
Practice Address - Street 2:T-0069
Practice Address - City:WEST DES MOINES
Practice Address - State:IA
Practice Address - Zip Code:50266-1104
Practice Address - Country:US
Practice Address - Phone:515-225-3170
Practice Address - Fax:515-802-3360
Is Sole Proprietor?:Yes
Enumeration Date:2011-06-04
Last Update Date:2012-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA20564183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist