Provider Demographics
NPI:1720332554
Name:DRUZGALA, AMY R (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:AMY
Middle Name:R
Last Name:DRUZGALA
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 1:526 IRWIN LN
Mailing Address - Street 2:
Mailing Address - City:SANTA ROSA
Mailing Address - State:CA
Mailing Address - Zip Code:95401-5606
Mailing Address - Country:US
Mailing Address - Phone:707-477-1176
Mailing Address - Fax:
Practice Address - Street 1:1799 MARLOW RD
Practice Address - Street 2:
Practice Address - City:SANTA ROSA
Practice Address - State:CA
Practice Address - Zip Code:95401-4474
Practice Address - Country:US
Practice Address - Phone:707-528-3730
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-10-31
Last Update Date:2012-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA47904183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist