Provider Demographics
NPI:1902409402
Name:AMAYA, ANDRES (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:ANDRES
Middle Name:
Last Name:AMAYA
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6609 WESTON CIR E
Mailing Address - Street 2:
Mailing Address - City:DUBLIN
Mailing Address - State:OH
Mailing Address - Zip Code:43016-9443
Mailing Address - Country:US
Mailing Address - Phone:614-806-0039
Mailing Address - Fax:
Practice Address - Street 1:6300 SCIOTO DARBY RD
Practice Address - Street 2:
Practice Address - City:HILLIARD
Practice Address - State:OH
Practice Address - Zip Code:43026-9726
Practice Address - Country:US
Practice Address - Phone:614-529-2604
Practice Address - Fax:614-529-2610
Is Sole Proprietor?:Yes
Enumeration Date:2020-11-17
Last Update Date:2020-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH03237238183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist