Provider Demographics
NPI:1962004549
Name:WELLS, AMY LUANNE (RPH)
Entity Type:Individual
Prefix:
First Name:AMY
Middle Name:LUANNE
Last Name:WELLS
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:33 BIRDALE DR
Mailing Address - Street 2:
Mailing Address - City:WEYERS CAVE
Mailing Address - State:VA
Mailing Address - Zip Code:24486-2470
Mailing Address - Country:US
Mailing Address - Phone:540-810-3380
Mailing Address - Fax:
Practice Address - Street 1:171 BURGESS RD
Practice Address - Street 2:
Practice Address - City:HARRISONBURG
Practice Address - State:VA
Practice Address - Zip Code:22801-3704
Practice Address - Country:US
Practice Address - Phone:540-433-1106
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-11-10
Last Update Date:2020-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0202011147183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist