Provider Demographics
NPI:1760082135
Name:HILL, AMANDA LEE (RPH)
Entity Type:Individual
Prefix:
First Name:AMANDA
Middle Name:LEE
Last Name:HILL
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:MANDY
Other - Middle Name:
Other - Last Name:HILL
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:18651 TRINITY CHURCH RD
Mailing Address - Street 2:
Mailing Address - City:PURCELLVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:20132-4125
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2350 S PLEASANT VALLEY RD
Practice Address - Street 2:
Practice Address - City:WINCHESTER
Practice Address - State:VA
Practice Address - Zip Code:22601-7006
Practice Address - Country:US
Practice Address - Phone:540-667-9111
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-10-27
Last Update Date:2020-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0202012690183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist