Provider Demographics
NPI:1902131311
Name:BENNETT, AMY TROMANS (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:AMY
Middle Name:TROMANS
Last Name:BENNETT
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 1:101 SMITH CHURCH RD
Mailing Address - Street 2:
Mailing Address - City:ROANOKE RAPIDS
Mailing Address - State:NC
Mailing Address - Zip Code:27870-4941
Mailing Address - Country:US
Mailing Address - Phone:252-535-4037
Mailing Address - Fax:252-535-4184
Practice Address - Street 1:101 SMITH CHURCH RD
Practice Address - Street 2:
Practice Address - City:ROANOKE RAPIDS
Practice Address - State:NC
Practice Address - Zip Code:27870-4941
Practice Address - Country:US
Practice Address - Phone:252-535-4037
Practice Address - Fax:252-535-4184
Is Sole Proprietor?:No
Enumeration Date:2009-10-03
Last Update Date:2009-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC19650183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist