Provider Demographics
NPI:1114424728
Name:PHILLIPS, SARAH (PHARMD)
Entity Type:Individual
Prefix:
First Name:SARAH
Middle Name:
Last Name:PHILLIPS
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:SARAH
Other - Middle Name:
Other - Last Name:ANDERSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PHARMD
Mailing Address - Street 1:16071 ROYAL RD
Mailing Address - Street 2:
Mailing Address - City:RAMSEY
Mailing Address - State:MN
Mailing Address - Zip Code:55303-8019
Mailing Address - Country:US
Mailing Address - Phone:612-834-9147
Mailing Address - Fax:
Practice Address - Street 1:6055 NATHAN LN N
Practice Address - Street 2:
Practice Address - City:PLYMOUTH
Practice Address - State:MN
Practice Address - Zip Code:55442-1674
Practice Address - Country:US
Practice Address - Phone:763-463-4400
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-04-10
Last Update Date:2018-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5302035033183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist