Provider Demographics
NPI:1942801717
Name:RUPP, AMBER RENEE (PHARMD)
Entity Type:Individual
Prefix:MRS
First Name:AMBER
Middle Name:RENEE
Last Name:RUPP
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 1:2632 LAKE MEADE RD
Mailing Address - Street 2:
Mailing Address - City:EAST BERLIN
Mailing Address - State:PA
Mailing Address - Zip Code:17316-9655
Mailing Address - Country:US
Mailing Address - Phone:717-451-4044
Mailing Address - Fax:
Practice Address - Street 1:1270 YORK RD
Practice Address - Street 2:
Practice Address - City:GETTYSBURG
Practice Address - State:PA
Practice Address - Zip Code:17325-7562
Practice Address - Country:US
Practice Address - Phone:717-334-1313
Practice Address - Fax:717-334-1796
Is Sole Proprietor?:Yes
Enumeration Date:2020-11-06
Last Update Date:2020-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARP443800183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist