Provider Demographics
NPI:1346830965
Name:SMITH, AMY (RPH)
Entity Type:Individual
Prefix:MRS
First Name:AMY
Middle Name:
Last Name:SMITH
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:AMY
Other - Middle Name:
Other - Last Name:HOPKINS
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:425 ORANGE TREE AVE
Mailing Address - Street 2:
Mailing Address - City:GALLOWAY
Mailing Address - State:NJ
Mailing Address - Zip Code:08205-5501
Mailing Address - Country:US
Mailing Address - Phone:609-254-5045
Mailing Address - Fax:
Practice Address - Street 1:1 ROUTE US 9 S
Practice Address - Street 2:
Practice Address - City:MARMORA
Practice Address - State:NJ
Practice Address - Zip Code:08223-1401
Practice Address - Country:US
Practice Address - Phone:609-390-0060
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-01-19
Last Update Date:2021-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ28RI02728700183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist