Provider Demographics
NPI:1629488531
Name:TABOR, AMBER (PHARM D)
Entity Type:Individual
Prefix:DR
First Name:AMBER
Middle Name:
Last Name:TABOR
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 1:14220 6 MILE RD NE
Mailing Address - Street 2:
Mailing Address - City:BELDING
Mailing Address - State:MI
Mailing Address - Zip Code:48809-9663
Mailing Address - Country:US
Mailing Address - Phone:616-717-1261
Mailing Address - Fax:
Practice Address - Street 1:11901 FULTON ST E
Practice Address - Street 2:
Practice Address - City:LOWELL
Practice Address - State:MI
Practice Address - Zip Code:49331-8613
Practice Address - Country:US
Practice Address - Phone:616-897-4733
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-04-30
Last Update Date:2014-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5302033085183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist