Provider Demographics
NPI:1073817342
Name:WESTENBARGER, SABRINA Y (RPH)
Entity Type:Individual
Prefix:
First Name:SABRINA
Middle Name:Y
Last Name:WESTENBARGER
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:200 GOVERNOR TREUTLEN RD
Mailing Address - Street 2:SUITE 20
Mailing Address - City:POOLER
Mailing Address - State:GA
Mailing Address - Zip Code:31322-3400
Mailing Address - Country:US
Mailing Address - Phone:912-748-5717
Mailing Address - Fax:
Practice Address - Street 1:200 GOVERNOR TREUTLEN RD
Practice Address - Street 2:SUITE 20
Practice Address - City:POOLER
Practice Address - State:GA
Practice Address - Zip Code:31322-3400
Practice Address - Country:US
Practice Address - Phone:912-748-5717
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-12-30
Last Update Date:2010-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARPH018855183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist