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Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.

AMANDA MARIE GOODALL, PHARMD

Active Sole Proprietor

AMANDA MARIE GOODALL, PHARMD is a Long-Term Care Pharmacy healthcare provider located in PORTAGE, Wisconsin. NPI 1578162954 is currently active in the NPPES registry. Verify at CMS.

Long-Term Care Pharmacy · PORTAGE, WI

Registration Details

NPI Number
1578162954
Provider Type
Individual
Gender
Female
NPI Issued
Oct 18, 2020 (5.8339971845267 yrs)
Last Updated
Oct 18, 2020
License
18793-40 (WI)
Sole Proprietor
Yes

Practice Information

Address
2950 NEW PINERY RD
PORTAGE, WI, 539019225
Browse WI providers · Browse ZIP 53901
Phone
6087421670
Fax
6087421769
Primary Specialty
Long-Term Care Pharmacy
3336C0003X
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.