Provider Demographics
NPI:1427796572
Name:SOMERS, AMANDA (RPH)
Entity type:Individual
Prefix:
First Name:AMANDA
Middle Name:
Last Name:SOMERS
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:96 CRAIWELL AVE
Mailing Address - Street 2:
Mailing Address - City:WEST SPRINGFIELD
Mailing Address - State:MA
Mailing Address - Zip Code:01089-2916
Mailing Address - Country:US
Mailing Address - Phone:508-320-9751
Mailing Address - Fax:
Practice Address - Street 1:700 MAIN ST STE 2
Practice Address - Street 2:
Practice Address - City:GREAT BARRINGTON
Practice Address - State:MA
Practice Address - Zip Code:01230-2175
Practice Address - Country:US
Practice Address - Phone:413-528-5460
Practice Address - Fax:413-528-5588
Is Sole Proprietor?:No
Enumeration Date:2022-05-26
Last Update Date:2022-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MAPH24445183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist