Provider Demographics
NPI:1770564023
Name:PERRY, AMY B (PHARMD)
Entity type:Individual
Prefix:
First Name:AMY
Middle Name:B
Last Name:PERRY
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 1:319 JOHNET DR
Mailing Address - Street 2:APT 7
Mailing Address - City:SAINT CLAIRSVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:43950-1028
Mailing Address - Country:US
Mailing Address - Phone:740-695-5676
Mailing Address - Fax:
Practice Address - Street 1:639 W MAIN ST
Practice Address - Street 2:
Practice Address - City:BARNESVILLE
Practice Address - State:OH
Practice Address - Zip Code:43713-1039
Practice Address - Country:US
Practice Address - Phone:740-425-5108
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-11-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH03-3-25769183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist