Provider Demographics
NPI:1720373558
Name:JUNKIN, AMY (RPH)
Entity Type:Individual
Prefix:MRS
First Name:AMY
Middle Name:
Last Name:JUNKIN
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2400 S TELEGRAPH RD
Mailing Address - Street 2:T-2178
Mailing Address - City:BLOOMFIELD HILLS
Mailing Address - State:MI
Mailing Address - Zip Code:48302-0255
Mailing Address - Country:US
Mailing Address - Phone:248-409-1952
Mailing Address - Fax:248-409-1962
Practice Address - Street 1:2400 S TELEGRAPH RD
Practice Address - Street 2:T-2178
Practice Address - City:BLOOMFIELD HILLS
Practice Address - State:MI
Practice Address - Zip Code:48302-0255
Practice Address - Country:US
Practice Address - Phone:248-409-1952
Practice Address - Fax:248-409-1962
Is Sole Proprietor?:Yes
Enumeration Date:2011-06-09
Last Update Date:2011-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5302028860183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist