Provider Demographics
NPI:1962006163
Name:MYERS, AMBER STARR (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:AMBER
Middle Name:STARR
Last Name:MYERS
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 1:101 W 1ST ST
Mailing Address - Street 2:
Mailing Address - City:RUSHVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:46173-1901
Mailing Address - Country:US
Mailing Address - Phone:765-932-4070
Mailing Address - Fax:765-938-3148
Practice Address - Street 1:101 W 1ST ST
Practice Address - Street 2:
Practice Address - City:RUSHVILLE
Practice Address - State:IN
Practice Address - Zip Code:46173-1901
Practice Address - Country:US
Practice Address - Phone:765-932-4070
Practice Address - Fax:765-938-3148
Is Sole Proprietor?:No
Enumeration Date:2020-11-28
Last Update Date:2020-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN26021726A183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist