Provider Demographics
NPI:1356850317
Name:RAMSEWAK-TO, AMANDA SHASHI
Entity Type:Individual
Prefix:MRS
First Name:AMANDA
Middle Name:SHASHI
Last Name:RAMSEWAK-TO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:SHASHI
Other - Middle Name:KAVITA
Other - Last Name:RAMSEWAK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:BSC
Mailing Address - Street 1:1205 N MEMORIAL PARKWAY
Mailing Address - Street 2:
Mailing Address - City:HUNTSVILLE
Mailing Address - State:AL
Mailing Address - Zip Code:35801
Mailing Address - Country:US
Mailing Address - Phone:256-519-2222
Mailing Address - Fax:
Practice Address - Street 1:1205 MEMORIAL PKWY NW
Practice Address - Street 2:
Practice Address - City:HUNTSVILLE
Practice Address - State:AL
Practice Address - Zip Code:35801-5930
Practice Address - Country:US
Practice Address - Phone:256-519-2222
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-09-21
Last Update Date:2017-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL17945183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist