Provider Demographics
NPI:1881294650
Name:WARD, AMY MICHELE (PHARMD)
Entity type:Individual
Prefix:
First Name:AMY
Middle Name:MICHELE
Last Name:WARD
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 1:990 MISSOURI AVE N
Mailing Address - Street 2:
Mailing Address - City:LARGO
Mailing Address - State:FL
Mailing Address - Zip Code:33770-1812
Mailing Address - Country:US
Mailing Address - Phone:727-581-9922
Mailing Address - Fax:727-586-2264
Practice Address - Street 1:990 MISSOURI AVE N
Practice Address - Street 2:
Practice Address - City:LARGO
Practice Address - State:FL
Practice Address - Zip Code:33770-1812
Practice Address - Country:US
Practice Address - Phone:727-581-9922
Practice Address - Fax:727-586-2264
Is Sole Proprietor?:Yes
Enumeration Date:2020-10-29
Last Update Date:2020-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS34958183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist