Provider Demographics
NPI:1750985123
Name:ASHTON, AMY DAVIS (PHARMD)
Entity type:Individual
Prefix:
First Name:AMY
Middle Name:DAVIS
Last Name:ASHTON
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 1:4605 RAMSGATE DR
Mailing Address - Street 2:
Mailing Address - City:TALLAHASSEE
Mailing Address - State:FL
Mailing Address - Zip Code:32309-2163
Mailing Address - Country:US
Mailing Address - Phone:850-228-8423
Mailing Address - Fax:
Practice Address - Street 1:1300 APALACHEE PKWY
Practice Address - Street 2:
Practice Address - City:TALLAHASSEE
Practice Address - State:FL
Practice Address - Zip Code:32301-3002
Practice Address - Country:US
Practice Address - Phone:850-877-5168
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-11-25
Last Update Date:2020-11-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS52067183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist