Provider Demographics
NPI:1649611732
Name:SHREWSBERRY, AMANDA GAIL (PHARMD)
Entity type:Individual
Prefix:DR
First Name:AMANDA
Middle Name:GAIL
Last Name:SHREWSBERRY
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 1:350 CARRIAGE DR
Mailing Address - Street 2:
Mailing Address - City:BECKLEY
Mailing Address - State:WV
Mailing Address - Zip Code:25801-2812
Mailing Address - Country:US
Mailing Address - Phone:304-252-5349
Mailing Address - Fax:304-252-5386
Practice Address - Street 1:350 CARRIAGE DR
Practice Address - Street 2:
Practice Address - City:BECKLEY
Practice Address - State:WV
Practice Address - Zip Code:25801-2812
Practice Address - Country:US
Practice Address - Phone:304-252-5349
Practice Address - Fax:304-252-5386
Is Sole Proprietor?:No
Enumeration Date:2013-07-17
Last Update Date:2013-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WVRP0008145183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist