| Amanda Huber, | |
|
103 Medicine Way Rd, Peridot, AZ 85542-5000 | |
| (217) 820-8705 | |
| Not Available |
| Full Name | Amanda Huber |
|---|---|
| Gender | Female |
| Speciality | Dietitian, Registered |
| Location | 103 Medicine Way Rd, Peridot, Arizona |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1033812581 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 133V00000X | Dietitian, Registered | (NU) | Primary |
| Provider Name | The Fort Defiance Indian Hospital Board, Incorporation |
|---|---|
| Provider Type | Part B Supplier - Clinic/group Practice |
| Provider Identifiers | NPI Number: 1477876639 PECOS PAC ID: 0941336697 Enrollment ID: O20100429001153 |
| Provider Name | San Carlos Apache Healthcare Corporation |
|---|---|
| Provider Type | Part B Supplier - Clinic/group Practice |
| Provider Identifiers | NPI Number: 1265813075 PECOS PAC ID: 0648580597 Enrollment ID: O20151105002091 |
| Mailing Address | Practice Location Address |
|---|---|
| Amanda Huber, 2209 Big Bend Rd, Taylorville, IL 62568-9101 Ph: (217) 820-8705 | Amanda Huber, 103 Medicine Way Rd, Peridot, AZ 85542-5000 Ph: (217) 820-8705 |
Layla Rose Wall, RD Dietitian Medicare: Accepting Medicare Assignments Practice Location: 103 Medicine Road, Peridot, AZ 85542 Phone: 928-475-1467 |
Tamara Scott, RDN Dietitian Medicare: Medicare Enrolled Practice Location: 103 Medicine Way Road, Peridot, AZ 85542 Phone: 928-475-1343 |
Mrs. Rachel Ann Shorthouse, MPH, MS, RD Dietitian Medicare: Medicare Enrolled Practice Location: 103 Medicine Way Road, San Carlos Apache Healthcare Corp, Peridot, AZ 85542 Phone: 928-475-1469 |