Provider Demographics
NPI:1144367202
Name:AMATO, CHADWICK JAMES (RPH)
Entity type:Individual
Prefix:
First Name:CHADWICK
Middle Name:JAMES
Last Name:AMATO
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6765 CHERRY RD
Mailing Address - Street 2:
Mailing Address - City:OCALA
Mailing Address - State:FL
Mailing Address - Zip Code:34472-8665
Mailing Address - Country:US
Mailing Address - Phone:352-624-3416
Mailing Address - Fax:
Practice Address - Street 1:15912 EAST STATE HIGHWAY 40
Practice Address - Street 2:WINN-DIXIE PHARMACY # 2206
Practice Address - City:SILVER SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:34488
Practice Address - Country:US
Practice Address - Phone:352-625-9385
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-01-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS0030255183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist