Provider Demographics
NPI:1972105120
Name:PEEVEY, AMY KATHLEEN (PHARM D)
Entity Type:Individual
Prefix:MRS
First Name:AMY
Middle Name:KATHLEEN
Last Name:PEEVEY
Suffix:
Gender:F
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 540
Mailing Address - Street 2:
Mailing Address - City:LAKE CITY
Mailing Address - State:AR
Mailing Address - Zip Code:72437-0540
Mailing Address - Country:US
Mailing Address - Phone:870-237-8010
Mailing Address - Fax:870-237-8003
Practice Address - Street 1:803 HIGHWAY 18 STE B
Practice Address - Street 2:
Practice Address - City:LAKE CITY
Practice Address - State:AR
Practice Address - Zip Code:72437-9603
Practice Address - Country:US
Practice Address - Phone:870-237-8010
Practice Address - Fax:870-237-8003
Is Sole Proprietor?:No
Enumeration Date:2020-11-12
Last Update Date:2020-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARPD10156183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist