Provider Demographics
NPI:1730415563
Name:ANDERSON, AMBER M (PHARMD)
Entity type:Individual
Prefix:
First Name:AMBER
Middle Name:M
Last Name:ANDERSON
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 1:3205 STOWER ST
Mailing Address - Street 2:
Mailing Address - City:MILES CITY
Mailing Address - State:MT
Mailing Address - Zip Code:59301-5785
Mailing Address - Country:US
Mailing Address - Phone:406-232-7320
Mailing Address - Fax:406-232-3296
Practice Address - Street 1:3205 STOWER ST
Practice Address - Street 2:
Practice Address - City:MILES CITY
Practice Address - State:MT
Practice Address - Zip Code:59301-5785
Practice Address - Country:US
Practice Address - Phone:406-232-7320
Practice Address - Fax:406-232-3296
Is Sole Proprietor?:No
Enumeration Date:2009-10-29
Last Update Date:2014-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WY3297183500000X
MT5973183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist