Provider Demographics
NPI:1477961522
Name:DELOSH, AMY CATHERINE (PHARM D)
Entity Type:Individual
Prefix:DR
First Name:AMY
Middle Name:CATHERINE
Last Name:DELOSH
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 1:4240 53RD AVE E
Mailing Address - Street 2:
Mailing Address - City:BRADENTON
Mailing Address - State:FL
Mailing Address - Zip Code:34203-8097
Mailing Address - Country:US
Mailing Address - Phone:941-758-3410
Mailing Address - Fax:941-538-6250
Practice Address - Street 1:4240 53RD AVE E
Practice Address - Street 2:
Practice Address - City:BRADENTON
Practice Address - State:FL
Practice Address - Zip Code:34203-8097
Practice Address - Country:US
Practice Address - Phone:941-758-3410
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-07-31
Last Update Date:2015-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS52160183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist