Provider Demographics
NPI:1114204435
Name:BURROUGHS, SARAH M
Entity Type:Individual
Prefix:
First Name:SARAH
Middle Name:M
Last Name:BURROUGHS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 CAVASINA DR
Mailing Address - Street 2:
Mailing Address - City:CANONSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:15317-1767
Mailing Address - Country:US
Mailing Address - Phone:724-873-8790
Mailing Address - Fax:
Practice Address - Street 1:100 CAVASINA DR
Practice Address - Street 2:
Practice Address - City:CANONSBURG
Practice Address - State:PA
Practice Address - Zip Code:15317-1767
Practice Address - Country:US
Practice Address - Phone:724-873-8790
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-11-15
Last Update Date:2022-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WVRP0007691183500000X
PARP444760183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist