Provider Demographics
NPI:1336741925
Name:BERNARDI, AMANDA SUE (PHARMD)
Entity Type:Individual
Prefix:
First Name:AMANDA
Middle Name:SUE
Last Name:BERNARDI
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 1:2 HOLLY RD
Mailing Address - Street 2:
Mailing Address - City:WHEELING
Mailing Address - State:WV
Mailing Address - Zip Code:26003-5657
Mailing Address - Country:US
Mailing Address - Phone:304-670-4683
Mailing Address - Fax:
Practice Address - Street 1:400 THREE SPRINGS DR
Practice Address - Street 2:
Practice Address - City:WEIRTON
Practice Address - State:WV
Practice Address - Zip Code:26062-4950
Practice Address - Country:US
Practice Address - Phone:304-723-3450
Practice Address - Fax:304-723-3452
Is Sole Proprietor?:Yes
Enumeration Date:2020-11-10
Last Update Date:2020-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WVRP0006899183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist