Provider Demographics
NPI:1346631629
Name:MARCHUS, AMY (PHARM D)
Entity Type:Individual
Prefix:
First Name:AMY
Middle Name:
Last Name:MARCHUS
Suffix:
Gender:F
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:211 FRAZEE ST E
Mailing Address - Street 2:
Mailing Address - City:DETROIT LAKES
Mailing Address - State:MN
Mailing Address - Zip Code:56501-3503
Mailing Address - Country:US
Mailing Address - Phone:218-847-3537
Mailing Address - Fax:218-847-4405
Practice Address - Street 1:211 FRAZEE ST E
Practice Address - Street 2:
Practice Address - City:DETROIT LAKES
Practice Address - State:MN
Practice Address - Zip Code:56501-3503
Practice Address - Country:US
Practice Address - Phone:218-847-3537
Practice Address - Fax:218-847-4405
Is Sole Proprietor?:No
Enumeration Date:2015-02-09
Last Update Date:2015-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN118849183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist