Provider Demographics
NPI:1972087062
Name:FRITZ, AMY JEAN (RPH)
Entity Type:Individual
Prefix:
First Name:AMY
Middle Name:JEAN
Last Name:FRITZ
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 1:165 HUNTER SCHOOL RD
Mailing Address - Street 2:
Mailing Address - City:SOMERSET
Mailing Address - State:PA
Mailing Address - Zip Code:15501-4328
Mailing Address - Country:US
Mailing Address - Phone:814-445-7623
Mailing Address - Fax:
Practice Address - Street 1:131 S PLEASANT AVE
Practice Address - Street 2:
Practice Address - City:SOMERSET
Practice Address - State:PA
Practice Address - Zip Code:15501-2189
Practice Address - Country:US
Practice Address - Phone:814-443-9500
Practice Address - Fax:814-445-5410
Is Sole Proprietor?:No
Enumeration Date:2018-09-24
Last Update Date:2018-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARP0410051183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist