Provider Demographics
NPI:1316386634
Name:ROBERSON, AMY R (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:AMY
Middle Name:R
Last Name:ROBERSON
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 1:1200 HIGHWAY 74 S
Mailing Address - Street 2:
Mailing Address - City:PEACHTREE CITY
Mailing Address - State:GA
Mailing Address - Zip Code:30269-3073
Mailing Address - Country:US
Mailing Address - Phone:770-486-5559
Mailing Address - Fax:
Practice Address - Street 1:1584 MONTGOMERY HWY
Practice Address - Street 2:
Practice Address - City:HOOVER
Practice Address - State:AL
Practice Address - Zip Code:35216-4524
Practice Address - Country:US
Practice Address - Phone:205-824-7223
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-06-19
Last Update Date:2021-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARPH029686183500000X
AL17329183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist