Provider Demographics
NPI:1457744252
Name:MCCALL, AMANDA (PHARMD)
Entity Type:Individual
Prefix:
First Name:AMANDA
Middle Name:
Last Name:MCCALL
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 1:6043 RELOCATION WAY
Mailing Address - Street 2:
Mailing Address - City:OOLTEWAH
Mailing Address - State:TN
Mailing Address - Zip Code:37363-6274
Mailing Address - Country:US
Mailing Address - Phone:423-238-5594
Mailing Address - Fax:
Practice Address - Street 1:6043 RELOCATION WAY
Practice Address - Street 2:
Practice Address - City:OOLTEWAH
Practice Address - State:TN
Practice Address - Zip Code:37363-6274
Practice Address - Country:US
Practice Address - Phone:423-238-5594
Practice Address - Fax:423-238-4119
Is Sole Proprietor?:Yes
Enumeration Date:2015-03-18
Last Update Date:2021-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL21653183500000X
GARPH025499183500000X
TN34198183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist