Provider Demographics
NPI:1326330937
Name:DUNDORE, AMY B (RPH)
Entity Type:Individual
Prefix:
First Name:AMY
Middle Name:B
Last Name:DUNDORE
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 1:1130 CUMBERLAND ST
Mailing Address - Street 2:
Mailing Address - City:LEBANON
Mailing Address - State:PA
Mailing Address - Zip Code:17042-5150
Mailing Address - Country:US
Mailing Address - Phone:717-273-2281
Mailing Address - Fax:717-272-4160
Practice Address - Street 1:1130 CUMBERLAND ST
Practice Address - Street 2:
Practice Address - City:LEBANON
Practice Address - State:PA
Practice Address - Zip Code:17042-5150
Practice Address - Country:US
Practice Address - Phone:717-273-2281
Practice Address - Fax:717-272-4160
Is Sole Proprietor?:No
Enumeration Date:2011-05-15
Last Update Date:2011-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARP040519L183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist