Provider Demographics
NPI:1659777555
Name:WOODS, AMANDA MICHELLE (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:AMANDA
Middle Name:MICHELLE
Last Name:WOODS
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 1:315 MEDICAL PARK DR
Mailing Address - Street 2:SUITE 204
Mailing Address - City:CONCORD
Mailing Address - State:NC
Mailing Address - Zip Code:28025-1902
Mailing Address - Country:US
Mailing Address - Phone:704-403-4499
Mailing Address - Fax:704-403-2524
Practice Address - Street 1:315 MEDICAL PARK DR
Practice Address - Street 2:SUITE 204
Practice Address - City:CONCORD
Practice Address - State:NC
Practice Address - Zip Code:28025-1902
Practice Address - Country:US
Practice Address - Phone:704-403-4499
Practice Address - Fax:704-403-2524
Is Sole Proprietor?:No
Enumeration Date:2014-11-05
Last Update Date:2014-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC23457183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist