Provider Demographics
NPI:1588797302
Name:GLOVER, AMANDA MARIE (PHARMD, CDM)
Entity Type:Individual
Prefix:DR
First Name:AMANDA
Middle Name:MARIE
Last Name:GLOVER
Suffix:
Gender:F
Credentials:PHARMD, CDM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:167 FAIRVIEW AVE
Mailing Address - Street 2:
Mailing Address - City:HOPE VALLEY
Mailing Address - State:RI
Mailing Address - Zip Code:02832-2116
Mailing Address - Country:US
Mailing Address - Phone:401-539-2372
Mailing Address - Fax:401-468-2870
Practice Address - Street 1:50 SERVICE AVE
Practice Address - Street 2:
Practice Address - City:WARWICK
Practice Address - State:RI
Practice Address - Zip Code:02886-1021
Practice Address - Country:US
Practice Address - Phone:401-468-2829
Practice Address - Fax:401-468-2870
Is Sole Proprietor?:No
Enumeration Date:2007-03-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIRPH04342183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist