Provider Demographics
NPI:1720608458
Name:KOJDA, AMANDA KINGA (PHARMD)
Entity type:Individual
Prefix:DR
First Name:AMANDA
Middle Name:KINGA
Last Name:KOJDA
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 1:470 TORRENCE AVE
Mailing Address - Street 2:
Mailing Address - City:CALUMET CITY
Mailing Address - State:IL
Mailing Address - Zip Code:60409-2306
Mailing Address - Country:US
Mailing Address - Phone:708-832-2943
Mailing Address - Fax:
Practice Address - Street 1:470 TORRENCE AVE
Practice Address - Street 2:
Practice Address - City:CALUMET CITY
Practice Address - State:IL
Practice Address - Zip Code:60409-2306
Practice Address - Country:US
Practice Address - Phone:708-832-2943
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-04-22
Last Update Date:2020-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL051302346183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist