Provider Demographics
NPI:1922392505
Name:HEBBARD, AMY M (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:AMY
Middle Name:M
Last Name:HEBBARD
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:DR
Other - First Name:AMY
Other - Middle Name:M
Other - Last Name:JOHNSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PHARMD
Mailing Address - Street 1:INSTITUTE OF PSYCHAITRY PHARMACY
Mailing Address - Street 2:67 PRESIDENT ST, ROOM 448N
Mailing Address - City:CHARLESTON
Mailing Address - State:SC
Mailing Address - Zip Code:29425-0001
Mailing Address - Country:US
Mailing Address - Phone:843-792-5952
Mailing Address - Fax:843-792-5954
Practice Address - Street 1:INSTITUTE OF PSYCHAITRY PHARMACY
Practice Address - Street 2:67 PRESIDENT ST, ROOM 448N
Practice Address - City:CHARLESTON
Practice Address - State:SC
Practice Address - Zip Code:29425-0001
Practice Address - Country:US
Practice Address - Phone:843-792-5952
Practice Address - Fax:843-792-5954
Is Sole Proprietor?:No
Enumeration Date:2011-06-01
Last Update Date:2011-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC12975183500000X
GARPH 024801183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist