Provider Demographics
NPI:1891146106
Name:WEGHORST, AMANDA (PHARMD, RPH)
Entity Type:Individual
Prefix:
First Name:AMANDA
Middle Name:
Last Name:WEGHORST
Suffix:
Gender:F
Credentials:PHARMD, RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:157 LOUDON RD
Mailing Address - Street 2:
Mailing Address - City:CONCORD
Mailing Address - State:NH
Mailing Address - Zip Code:03301-5610
Mailing Address - Country:US
Mailing Address - Phone:603-225-0793
Mailing Address - Fax:603-225-0825
Practice Address - Street 1:157 LOUDON RD
Practice Address - Street 2:
Practice Address - City:CONCORD
Practice Address - State:NH
Practice Address - Zip Code:03301-5610
Practice Address - Country:US
Practice Address - Phone:603-225-0793
Practice Address - Fax:603-225-0825
Is Sole Proprietor?:No
Enumeration Date:2016-06-28
Last Update Date:2016-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH3782183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist