Provider Demographics
NPI:1629345939
Name:CREEDEN, AMANDA (PHARMD)
Entity type:Individual
Prefix:DR
First Name:AMANDA
Middle Name:
Last Name:CREEDEN
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 1:1800 SOUTH ST
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19146-1419
Mailing Address - Country:US
Mailing Address - Phone:484-716-5898
Mailing Address - Fax:
Practice Address - Street 1:127 MEADOWBROOK LN
Practice Address - Street 2:
Practice Address - City:BROOKHAVEN
Practice Address - State:PA
Practice Address - Zip Code:19015-2812
Practice Address - Country:US
Practice Address - Phone:484-716-5898
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-11-30
Last Update Date:2020-12-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARPI005038183500000X
PARP445730183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist