Decker, Amanda Sue

Decker, Amanda Sue is an individual health care provider with primary practice located at 1232 Branson Hills Pkwy Ste 205, Branson MO 65616-9943. She recently has only one registered license in Pharmacy Service Providers / Pharmacist, which is considered as her primary health care specialty. Decker, Amanda Sue can be contacted via phone (417) 336-4701.

Contact Information

Primary practice address
1232 Branson Hills Pkwy Ste 205 Branson MO 65616-9943
Phone: (417) 336-4701
Fax: (417) 336-2772
Website:
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Health care specialties

SpecialtyCodeLicense #State
Pharmacy Service Providers / Pharmacist 183500000X 2001023388 Missouri
Pharmacy Service Providers / Pharmacist 183500000X PD09323 Arkansas

Profile Details

NPI number 1396756359
LBN Legal business name Decker, Amanda Sue
Credentials PHARMD
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 11th, 2006
Last updated Feb 26th, 2013 - about 12 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1396756359 NPPES
Arkansas Other PD09323 AR LISC
Arkansas Other 2001023388 AR LISC
Arkansas MEDICAID 35914908 AR LISC

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