Provider Demographics
NPI:1316024011
Name:VARNELL, AMY R (RPH)
Entity Type:Individual
Prefix:MRS
First Name:AMY
Middle Name:R
Last Name:VARNELL
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 1:2152 HALL RD
Mailing Address - Street 2:
Mailing Address - City:JEFFERSON
Mailing Address - State:TX
Mailing Address - Zip Code:75657-7191
Mailing Address - Country:US
Mailing Address - Phone:903-665-7460
Mailing Address - Fax:
Practice Address - Street 1:404 N KAUFMAN ST
Practice Address - Street 2:
Practice Address - City:LINDEN
Practice Address - State:TX
Practice Address - Zip Code:75563-5234
Practice Address - Country:US
Practice Address - Phone:903-756-9871
Practice Address - Fax:903-756-8438
Is Sole Proprietor?:No
Enumeration Date:2006-11-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX34900183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist