Provider Demographics
NPI:1083200133
Name:EGBERT, SAVANAH SPRING (PHARMD)
Entity Type:Individual
Prefix:
First Name:SAVANAH
Middle Name:SPRING
Last Name:EGBERT
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:665 COUNTRY DR
Mailing Address - Street 2:
Mailing Address - City:FERNLEY
Mailing Address - State:NV
Mailing Address - Zip Code:89408-9018
Mailing Address - Country:US
Mailing Address - Phone:208-241-6257
Mailing Address - Fax:
Practice Address - Street 1:1550 NEWLANDS DR E
Practice Address - Street 2:
Practice Address - City:FERNLEY
Practice Address - State:NV
Practice Address - Zip Code:89408-8910
Practice Address - Country:US
Practice Address - Phone:775-575-6198
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-12-14
Last Update Date:2020-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV18558183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist