Provider Demographics
NPI:1851016711
Name:SAINT-AMAND, MADISON
Entity Type:Individual
Prefix:
First Name:MADISON
Middle Name:
Last Name:SAINT-AMAND
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:701 DOCTORS DR STE P
Mailing Address - Street 2:
Mailing Address - City:KINSTON
Mailing Address - State:NC
Mailing Address - Zip Code:28501-1584
Mailing Address - Country:US
Mailing Address - Phone:252-523-3187
Mailing Address - Fax:252-522-2988
Practice Address - Street 1:701 DOCTORS DR STE P
Practice Address - Street 2:
Practice Address - City:KINSTON
Practice Address - State:NC
Practice Address - Zip Code:28501-1584
Practice Address - Country:US
Practice Address - Phone:252-523-3187
Practice Address - Fax:252-522-2988
Is Sole Proprietor?:No
Enumeration Date:2022-10-04
Last Update Date:2023-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC30629183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist