Provider Demographics
NPI:1528242450
Name:MURPHY, AMY (RPH)
Entity type:Individual
Prefix:
First Name:AMY
Middle Name:
Last Name:MURPHY
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 1:887 STATE ROUTE 11
Mailing Address - Street 2:PO BOX 576
Mailing Address - City:CHAMPLAIN
Mailing Address - State:NY
Mailing Address - Zip Code:12919
Mailing Address - Country:US
Mailing Address - Phone:518-298-2975
Mailing Address - Fax:518-298-3142
Practice Address - Street 1:887 STATE ROUTE 11
Practice Address - Street 2:
Practice Address - City:CHAMPLAIN
Practice Address - State:NY
Practice Address - Zip Code:12919
Practice Address - Country:US
Practice Address - Phone:518-298-2975
Practice Address - Fax:518-298-3142
Is Sole Proprietor?:No
Enumeration Date:2007-12-27
Last Update Date:2007-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY047515183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01692093Medicaid