Provider Demographics
NPI:1154874360
Name:KORN, AMBER SWANN (PHARMD)
Entity type:Individual
Prefix:
First Name:AMBER
Middle Name:SWANN
Last Name:KORN
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 1:407 FOXHOUND RD
Mailing Address - Street 2:
Mailing Address - City:SIMPSONVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29680-6716
Mailing Address - Country:US
Mailing Address - Phone:828-545-2344
Mailing Address - Fax:
Practice Address - Street 1:805 FAIRVIEW RD
Practice Address - Street 2:
Practice Address - City:ASHEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28803-1011
Practice Address - Country:US
Practice Address - Phone:828-298-3636
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-07-25
Last Update Date:2016-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC26296183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist