Provider Demographics
NPI:1316155682
Name:HANNIG, AMY CHRISTINE
Entity type:Individual
Prefix:DR
First Name:AMY
Middle Name:CHRISTINE
Last Name:HANNIG
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:601 CHESTNUT LN
Mailing Address - Street 2:
Mailing Address - City:BOARDMAN
Mailing Address - State:OH
Mailing Address - Zip Code:44512-4777
Mailing Address - Country:US
Mailing Address - Phone:330-318-7777
Mailing Address - Fax:
Practice Address - Street 1:1419 BOARDMAN CANFIELD RD
Practice Address - Street 2:KIDS N CURES PHARMACY
Practice Address - City:BOARDMAN
Practice Address - State:OH
Practice Address - Zip Code:44512-8062
Practice Address - Country:US
Practice Address - Phone:330-629-9714
Practice Address - Fax:330-629-9873
Is Sole Proprietor?:No
Enumeration Date:2007-05-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH03-2-25155183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist