Provider Demographics
NPI:1891131389
Name:HAYES, AMANDA ROSE (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:AMANDA
Middle Name:ROSE
Last Name:HAYES
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:DR
Other - First Name:AMANDA
Other - Middle Name:ROSE
Other - Last Name:DAVIS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PHARMD
Mailing Address - Street 1:1115 ELKTON DR STE 300-P
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80907-8507
Mailing Address - Country:US
Mailing Address - Phone:719-257-6928
Mailing Address - Fax:719-867-4555
Practice Address - Street 1:1115 ELKTON DR STE 300-P
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80907-8507
Practice Address - Country:US
Practice Address - Phone:719-257-6928
Practice Address - Fax:719-867-4555
Is Sole Proprietor?:No
Enumeration Date:2013-05-11
Last Update Date:2023-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA66221183500000X
CO0019810183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist