Provider Demographics
NPI:1326611807
Name:GODFREY, AMELIA MARIE (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:AMELIA
Middle Name:MARIE
Last Name:GODFREY
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:AMELIA
Other - Middle Name:MARIE
Other - Last Name:ROSENKRANS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:4 POPLAR DR
Mailing Address - Street 2:
Mailing Address - City:MILLS RIVER
Mailing Address - State:NC
Mailing Address - Zip Code:28759-2656
Mailing Address - Country:US
Mailing Address - Phone:573-795-6231
Mailing Address - Fax:
Practice Address - Street 1:128 CROSS ROAD DR
Practice Address - Street 2:
Practice Address - City:MILLS RIVER
Practice Address - State:NC
Practice Address - Zip Code:28759-5508
Practice Address - Country:US
Practice Address - Phone:828-891-4585
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-07-21
Last Update Date:2023-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC30537183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist