Individual
DR. AMY LY-HA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHARMD
Contact information
Practice address
2500 N STATE ST, JACKSON, MS 39216-4500
(601) 984-4201
Mailing address
1227 PIN OAK DR APT O11, FLOWOOD, MS 39232-9547
(832) 600-2383
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
E-100822
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
E-100822
PHARMACIST LICENSE NUMBER
MS
Enumeration date
09/22/2022
Last updated
09/22/2022
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