Provider Demographics
NPI:1528220498
Name:VOGT, AMY MARIE (PHARM D)
Entity type:Individual
Prefix:DR
First Name:AMY
Middle Name:MARIE
Last Name:VOGT
Suffix:
Gender:F
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:665 3RD ST SW
Mailing Address - Street 2:SUITE 100
Mailing Address - City:PERHAM
Mailing Address - State:MN
Mailing Address - Zip Code:56573-1137
Mailing Address - Country:US
Mailing Address - Phone:218-346-4550
Mailing Address - Fax:218-346-1279
Practice Address - Street 1:665 3RD ST SW
Practice Address - Street 2:SUITE 100
Practice Address - City:PERHAM
Practice Address - State:MN
Practice Address - Zip Code:56573-1137
Practice Address - Country:US
Practice Address - Phone:218-346-4550
Practice Address - Fax:218-346-1279
Is Sole Proprietor?:No
Enumeration Date:2008-07-01
Last Update Date:2008-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN119276183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist