Provider Demographics
NPI:1114514866
Name:PAPPAS, SANDRA ANNE (RPH)
Entity Type:Individual
Prefix:
First Name:SANDRA
Middle Name:ANNE
Last Name:PAPPAS
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 1:127 ARK RD
Mailing Address - Street 2:
Mailing Address - City:MOUNT LAUREL
Mailing Address - State:NJ
Mailing Address - Zip Code:08054-6302
Mailing Address - Country:US
Mailing Address - Phone:856-359-2181
Mailing Address - Fax:856-359-2190
Practice Address - Street 1:127 ARK RD
Practice Address - Street 2:
Practice Address - City:MOUNT LAUREL
Practice Address - State:NJ
Practice Address - Zip Code:08054-6302
Practice Address - Country:US
Practice Address - Phone:856-359-2181
Practice Address - Fax:856-359-2190
Is Sole Proprietor?:No
Enumeration Date:2020-12-29
Last Update Date:2020-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ28RI02562500183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist