Provider Demographics
NPI:1982039012
Name:SPELLMAN, AMY L (RPH)
Entity Type:Individual
Prefix:MRS
First Name:AMY
Middle Name:L
Last Name:SPELLMAN
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 1:1995 E COALTON RD
Mailing Address - Street 2:#43-204
Mailing Address - City:SUPERIOR
Mailing Address - State:CO
Mailing Address - Zip Code:80027-4419
Mailing Address - Country:US
Mailing Address - Phone:618-303-6358
Mailing Address - Fax:
Practice Address - Street 1:1995 E COALTON RD
Practice Address - Street 2:#43-204
Practice Address - City:SUPERIOR
Practice Address - State:CO
Practice Address - Zip Code:80027-4419
Practice Address - Country:US
Practice Address - Phone:618-303-6358
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-09-09
Last Update Date:2013-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COPHA.0019873183500000X
MI5302031385183500000X
IL051.286949183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist