Provider Demographics
NPI:1861023053
Name:PHILLIPS, AMY MARIE (PHARMD)
Entity Type:Individual
Prefix:
First Name:AMY
Middle Name:MARIE
Last Name:PHILLIPS
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:AMY
Other - Middle Name:M
Other - Last Name:PHILLIPS
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PHARMD
Mailing Address - Street 1:6950 MIAMI AVE
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45243-2633
Mailing Address - Country:US
Mailing Address - Phone:513-271-1360
Mailing Address - Fax:513-271-4021
Practice Address - Street 1:6950 MIAMI AVE
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45243-2633
Practice Address - Country:US
Practice Address - Phone:513-271-1360
Practice Address - Fax:513-271-4021
Is Sole Proprietor?:No
Enumeration Date:2020-01-28
Last Update Date:2020-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY0130121835P0018X
OH033268901835P0018X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P0018XPharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist