Provider Demographics
NPI:1740554617
Name:AMAZING PHARMACY INC
Entity type:Organization
Organization Name:AMAZING PHARMACY INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER/PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ERIC
Authorized Official - Middle Name:
Authorized Official - Last Name:NKANSAH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:610-453-2423
Mailing Address - Street 1:814 ARTHUR SPRINGS LN
Mailing Address - Street 2:
Mailing Address - City:NEW CASTLE
Mailing Address - State:DE
Mailing Address - Zip Code:19720-8771
Mailing Address - Country:US
Mailing Address - Phone:610-453-2423
Mailing Address - Fax:302-543-5408
Practice Address - Street 1:205 W 4TH ST
Practice Address - Street 2:
Practice Address - City:WILMINGTON
Practice Address - State:DE
Practice Address - Zip Code:19801-2204
Practice Address - Country:US
Practice Address - Phone:302-543-5049
Practice Address - Fax:302-543-5408
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-02-23
Last Update Date:2016-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
333600000X
DEA3-00009303336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
2133950OtherPK
0845252OtherNCPDP PROVIDER IDENTIFICATION NUMBER