Provider Demographics
NPI:1922725977
Name:AMEDIE, GETACHEW ALI (PHARMACIST)
Entity Type:Individual
Prefix:DR
First Name:GETACHEW
Middle Name:ALI
Last Name:AMEDIE
Suffix:
Gender:M
Credentials:PHARMACIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:28 ABBY RD
Mailing Address - Street 2:
Mailing Address - City:PALMYRA
Mailing Address - State:VA
Mailing Address - Zip Code:22963-2085
Mailing Address - Country:US
Mailing Address - Phone:434-589-2278
Mailing Address - Fax:
Practice Address - Street 1:28 ABBY RD
Practice Address - Street 2:
Practice Address - City:PALMYRA
Practice Address - State:VA
Practice Address - Zip Code:22963-2085
Practice Address - Country:US
Practice Address - Phone:434-589-2278
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-10-20
Last Update Date:2022-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARN694097163WE0003X
PARP456546183500000X
VA0202220329183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
No163WE0003XNursing Service ProvidersRegistered NurseEmergency