Provider Demographics
NPI:1992397004
Name:BARBER, AMANDA LEE (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:AMANDA
Middle Name:LEE
Last Name:BARBER
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 1:398 E DORTON BLVD
Mailing Address - Street 2:
Mailing Address - City:STAFFORDSVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:41256-9011
Mailing Address - Country:US
Mailing Address - Phone:606-298-7283
Mailing Address - Fax:606-298-4538
Practice Address - Street 1:2160 BLACKLOG RD STE 100
Practice Address - Street 2:
Practice Address - City:INEZ
Practice Address - State:KY
Practice Address - Zip Code:41224-9019
Practice Address - Country:US
Practice Address - Phone:606-298-7283
Practice Address - Fax:606-298-4538
Is Sole Proprietor?:No
Enumeration Date:2021-02-09
Last Update Date:2021-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY017649183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY1609924653OtherEMPLOYER PHARMACY NPI