Provider Demographics
NPI:1245833763
Name:CHASE, AMANDA C (PHARMD)
Entity type:Individual
Prefix:
First Name:AMANDA
Middle Name:C
Last Name:CHASE
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 1:1761 RUSTICWOOD LN
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45255-2457
Mailing Address - Country:US
Mailing Address - Phone:216-970-5469
Mailing Address - Fax:
Practice Address - Street 1:3086 MADISON RD
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45209-1723
Practice Address - Country:US
Practice Address - Phone:513-321-9980
Practice Address - Fax:513-321-0582
Is Sole Proprietor?:No
Enumeration Date:2020-11-18
Last Update Date:2021-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH032369481835P2201X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P2201XPharmacy Service ProvidersPharmacistAmbulatory Care