Provider Demographics
NPI:1922522952
Name:AMADI, REGINA (PHARM D)
Entity Type:Individual
Prefix:MRS
First Name:REGINA
Middle Name:
Last Name:AMADI
Suffix:
Gender:F
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3129 GOLFVIEW DR
Mailing Address - Street 2:
Mailing Address - City:SALINE
Mailing Address - State:MI
Mailing Address - Zip Code:48176-9245
Mailing Address - Country:US
Mailing Address - Phone:734-330-3262
Mailing Address - Fax:734-429-9070
Practice Address - Street 1:30785 ANN ARBOR TRAIL
Practice Address - Street 2:
Practice Address - City:WESTLAND
Practice Address - State:MI
Practice Address - Zip Code:48185
Practice Address - Country:US
Practice Address - Phone:734-469-2424
Practice Address - Fax:734-469-2428
Is Sole Proprietor?:Yes
Enumeration Date:2017-08-01
Last Update Date:2017-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5302029358183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist