Provider Demographics
NPI:1881996312
Name:OATES, AMANDA LEE (PHARM D)
Entity type:Individual
Prefix:DR
First Name:AMANDA
Middle Name:LEE
Last Name:OATES
Suffix:
Gender:F
Credentials:PHARM D
Other - Prefix:DR
Other - First Name:AMANDA
Other - Middle Name:LEE
Other - Last Name:HALL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PHARM D
Mailing Address - Street 1:547 SHEPHERD RD
Mailing Address - Street 2:
Mailing Address - City:TROUTMAN
Mailing Address - State:NC
Mailing Address - Zip Code:28166-8755
Mailing Address - Country:US
Mailing Address - Phone:704-651-9840
Mailing Address - Fax:
Practice Address - Street 1:547 SHEPHERD RD
Practice Address - Street 2:
Practice Address - City:TROUTMAN
Practice Address - State:NC
Practice Address - Zip Code:28166-8755
Practice Address - Country:US
Practice Address - Phone:704-651-9840
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-12-05
Last Update Date:2021-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC19855183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist