Provider Demographics
NPI:1922263094
Name:WARD, AMANDA JO (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:AMANDA
Middle Name:JO
Last Name:WARD
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:DR
Other - First Name:AMANDA
Other - Middle Name:JO
Other - Last Name:PRESTON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PHARMD
Mailing Address - Street 1:2673 HIGHWAY 644 STE 1
Mailing Address - Street 2:RITE-VALUE PHARMACY
Mailing Address - City:LOUISA
Mailing Address - State:KY
Mailing Address - Zip Code:41230-5922
Mailing Address - Country:US
Mailing Address - Phone:606-638-9627
Mailing Address - Fax:606-638-4169
Practice Address - Street 1:2673 HIGHWAY 644 STE 1
Practice Address - Street 2:RITE-VALUE PHARMACY
Practice Address - City:LOUISA
Practice Address - State:KY
Practice Address - Zip Code:41230-5922
Practice Address - Country:US
Practice Address - Phone:606-638-9627
Practice Address - Fax:606-638-4169
Is Sole Proprietor?:No
Enumeration Date:2008-07-28
Last Update Date:2011-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHRPH.03129990-11835G0303X
KY0142051835G0303X
WVRP00071401835G0303X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835G0303XPharmacy Service ProvidersPharmacistGeriatric