Provider Demographics
NPI:1578852281
Name:PHELPS, AMY CORINNE (RPH)
Entity Type:Individual
Prefix:MS
First Name:AMY
Middle Name:CORINNE
Last Name:PHELPS
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:MRS
Other - First Name:AMY
Other - Middle Name:CORINNE
Other - Last Name:MAYS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:641 NAAMANS ROAD
Mailing Address - Street 2:
Mailing Address - City:CLAYMONT
Mailing Address - State:DE
Mailing Address - Zip Code:19703
Mailing Address - Country:US
Mailing Address - Phone:302-798-6866
Mailing Address - Fax:302-798-1413
Practice Address - Street 1:641 NAAMANS RD
Practice Address - Street 2:
Practice Address - City:CLAYMONT
Practice Address - State:DE
Practice Address - Zip Code:19703-2309
Practice Address - Country:US
Practice Address - Phone:302-798-6866
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-04-04
Last Update Date:2015-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEA1-0002851183500000X
PARP041487L183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist