Provider Demographics
NPI:1639447261
Name:CHRISTOPHER, AMY IRENE (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:AMY
Middle Name:IRENE
Last Name:CHRISTOPHER
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:1 MEDICAL VILLAGE DR
Mailing Address - Street 2:SEH EDGEWOOD ANTICOAGULATION CLINIC
Mailing Address - City:EDGEWOOD
Mailing Address - State:KY
Mailing Address - Zip Code:41017-3403
Mailing Address - Country:US
Mailing Address - Phone:859-301-6790
Mailing Address - Fax:859-301-6791
Practice Address - Street 1:1 MEDICAL VILLAGE DR
Practice Address - Street 2:SEH EDGEWOOD ANTICOAGULATION CLINIC
Practice Address - City:EDGEWOOD
Practice Address - State:KY
Practice Address - Zip Code:41017-3403
Practice Address - Country:US
Practice Address - Phone:859-301-6790
Practice Address - Fax:859-301-6791
Is Sole Proprietor?:Yes
Enumeration Date:2011-12-09
Last Update Date:2011-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY0118651835P0018X
OH03-3-256231835P0018X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P0018XPharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY011865OtherKENTUCKY PHARMACY LICENSE
OH03-3-25623OtherOHIO PHARMACY LICENSE