Provider Demographics
NPI:1912041336
Name:GRIMSLEY, AMY CHRISTINE (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:AMY
Middle Name:CHRISTINE
Last Name:GRIMSLEY
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:DR
Other - First Name:AMY
Other - Middle Name:CHRISTINE
Other - Last Name:MITCHELL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PHARMD
Mailing Address - Street 1:5204 TUCKERMAN LN
Mailing Address - Street 2:APT 306
Mailing Address - City:ROCKVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20852-6639
Mailing Address - Country:US
Mailing Address - Phone:478-461-0676
Mailing Address - Fax:
Practice Address - Street 1:10 CENTER DR
Practice Address - Street 2:RM 1C240 MSC 1196
Practice Address - City:BETHESDA
Practice Address - State:MD
Practice Address - Zip Code:20892-0001
Practice Address - Country:US
Practice Address - Phone:301-435-0896
Practice Address - Fax:301-496-0210
Is Sole Proprietor?:No
Enumeration Date:2007-02-18
Last Update Date:2011-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARPH023166183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist