Most Relevant Information
Provider Data
| NPI Number: | 1003417569 |
| Provider Name: | AMANDA RUGGERI |
| Entity Type: | Individual |
| Taxonomy Code: | 183500000X |
| Specialty: | Pharmacist |
| License Number: | 051288099 |
Most Important Dates
| Enumeration Date: | 11/02/2020 |
| Last Updated: | 11/02/2020 |
Provider Practice Location
1713 S PARK AVE
HERRIN
IL
629484166
Practice Location Phone/Fax
| Phone: | 6189426641 |
| Fax: |
Provider Mailing Location
172 CIRCLE DR
HERRIN
IL
629484302
Provider Mailing Phone/Fax
| Phone: | |
| Fax: |