Provider Demographics
NPI:1568710184
Name:MORROW, AMANDA MORRIS (RPH)
Entity Type:Individual
Prefix:MRS
First Name:AMANDA
Middle Name:MORRIS
Last Name:MORROW
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:MRS
Other - First Name:AMANDA
Other - Middle Name:MORRIS
Other - Last Name:COMBS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RPH
Mailing Address - Street 1:106 INDIAN TRAIL RD S
Mailing Address - Street 2:PO BOX 86
Mailing Address - City:INDIAN TRAIL
Mailing Address - State:NC
Mailing Address - Zip Code:28079-9669
Mailing Address - Country:US
Mailing Address - Phone:704-821-7617
Mailing Address - Fax:704-821-0177
Practice Address - Street 1:106 INDIAN TRAIL RD S
Practice Address - Street 2:
Practice Address - City:INDIAN TRAIL
Practice Address - State:NC
Practice Address - Zip Code:28079-9669
Practice Address - Country:US
Practice Address - Phone:704-821-7617
Practice Address - Fax:704-821-0177
Is Sole Proprietor?:No
Enumeration Date:2012-08-29
Last Update Date:2012-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCNC11807183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist