Provider Demographics
NPI:1346845559
Name:ZHOU, AMANDA MENGYUAN (PHARMD, RPH)
Entity Type:Individual
Prefix:
First Name:AMANDA
Middle Name:MENGYUAN
Last Name:ZHOU
Suffix:
Gender:F
Credentials:PHARMD, RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2345 EDGCUMBE RD
Mailing Address - Street 2:
Mailing Address - City:SAINT PAUL
Mailing Address - State:MN
Mailing Address - Zip Code:55116-2766
Mailing Address - Country:US
Mailing Address - Phone:612-666-2865
Mailing Address - Fax:
Practice Address - Street 1:2850 26TH AVE S
Practice Address - Street 2:
Practice Address - City:MINNEAPOLIS
Practice Address - State:MN
Practice Address - Zip Code:55406-4129
Practice Address - Country:US
Practice Address - Phone:612-721-5840
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-12-03
Last Update Date:2020-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN123326183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN123326OtherPHARMACIST LICENSE NUMBER