Provider Demographics
NPI:1922508712
Name:ASHLEY, AMBER (PHARMD)
Entity Type:Individual
Prefix:
First Name:AMBER
Middle Name:
Last Name:ASHLEY
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:224 MAGNOLIA RIDGE PL APT 302
Mailing Address - Street 2:
Mailing Address - City:DOTHAN
Mailing Address - State:AL
Mailing Address - Zip Code:36303-7425
Mailing Address - Country:US
Mailing Address - Phone:256-762-9036
Mailing Address - Fax:
Practice Address - Street 1:847 BOLL WEEVIL CIR STE 112
Practice Address - Street 2:
Practice Address - City:ENTERPRISE
Practice Address - State:AL
Practice Address - Zip Code:36330-2476
Practice Address - Country:US
Practice Address - Phone:334-348-1526
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-02-18
Last Update Date:2018-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL20156183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist