Provider Demographics
NPI:1003173626
Name:WOLDRING, AMY O'NEILL (RPH)
Entity type:Individual
Prefix:MRS
First Name:AMY
Middle Name:O'NEILL
Last Name:WOLDRING
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 1:8870 EASTWAY DR
Mailing Address - Street 2:
Mailing Address - City:WHITE LAKE
Mailing Address - State:MI
Mailing Address - Zip Code:48386-3574
Mailing Address - Country:US
Mailing Address - Phone:248-896-5453
Mailing Address - Fax:
Practice Address - Street 1:495 HAGGERTY HWY
Practice Address - Street 2:
Practice Address - City:COMMERCE TOWNSHIP
Practice Address - State:MI
Practice Address - Zip Code:48390-3936
Practice Address - Country:US
Practice Address - Phone:248-960-1401
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-04-20
Last Update Date:2012-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5302029680183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist