Provider Demographics
NPI:1649579400
Name:SAAD, AMY BOSTIC (PHARMD)
Entity Type:Individual
Prefix:
First Name:AMY
Middle Name:BOSTIC
Last Name:SAAD
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:676 MOSSWOOD LN
Mailing Address - Street 2:
Mailing Address - City:SPARTANBURG
Mailing Address - State:SC
Mailing Address - Zip Code:29301-5352
Mailing Address - Country:US
Mailing Address - Phone:864-641-5082
Mailing Address - Fax:
Practice Address - Street 1:2000 S PINE ST
Practice Address - Street 2:
Practice Address - City:SPARTANBURG
Practice Address - State:SC
Practice Address - Zip Code:29302-3315
Practice Address - Country:US
Practice Address - Phone:864-542-1426
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-03-19
Last Update Date:2011-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC11798183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist