Provider Demographics
NPI:1356780555
Name:AMOAH, CROSBY (PHARMD)
Entity type:Individual
Prefix:DR
First Name:CROSBY
Middle Name:
Last Name:AMOAH
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3410 TEWKESBURY RD
Mailing Address - Street 2:
Mailing Address - City:ABINGDON
Mailing Address - State:MD
Mailing Address - Zip Code:21009-1094
Mailing Address - Country:US
Mailing Address - Phone:443-739-4234
Mailing Address - Fax:
Practice Address - Street 1:3410 TEWKESBURY RD
Practice Address - Street 2:
Practice Address - City:ABINGDON
Practice Address - State:MD
Practice Address - Zip Code:21009-1094
Practice Address - Country:US
Practice Address - Phone:443-739-4234
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-06-20
Last Update Date:2013-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD203521835P0018X
DEA1-00042401835P0018X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P0018XPharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist