Provider Demographics
NPI:1265785752
Name:SCHELLPFEFFER, AMY (RPH)
Entity type:Individual
Prefix:
First Name:AMY
Middle Name:
Last Name:SCHELLPFEFFER
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 1:1117 VELVET LEAF DR
Mailing Address - Street 2:
Mailing Address - City:MADISON
Mailing Address - State:WI
Mailing Address - Zip Code:53719-4509
Mailing Address - Country:US
Mailing Address - Phone:608-833-8473
Mailing Address - Fax:608-222-0578
Practice Address - Street 1:2101 W BROADWAY
Practice Address - Street 2:
Practice Address - City:MONONA
Practice Address - State:WI
Practice Address - Zip Code:53713-1638
Practice Address - Country:US
Practice Address - Phone:608-222-2066
Practice Address - Fax:608-222-0578
Is Sole Proprietor?:No
Enumeration Date:2012-10-21
Last Update Date:2012-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI12907-40183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist