Provider Demographics
NPI:1134488588
Name:ZARAGOZA, SANDRA M (RPH)
Entity Type:Individual
Prefix:MRS
First Name:SANDRA
Middle Name:M
Last Name:ZARAGOZA
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:PO BOX 402
Mailing Address - Street 2:
Mailing Address - City:CAMDEN
Mailing Address - State:DE
Mailing Address - Zip Code:19934-0402
Mailing Address - Country:US
Mailing Address - Phone:302-387-1590
Mailing Address - Fax:302-387-1744
Practice Address - Street 1:2 S MAIN ST
Practice Address - Street 2:
Practice Address - City:CAMDEN
Practice Address - State:DE
Practice Address - Zip Code:19934-1319
Practice Address - Country:US
Practice Address - Phone:302-387-1590
Practice Address - Fax:302-387-1744
Is Sole Proprietor?:No
Enumeration Date:2012-05-04
Last Update Date:2012-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEA1-0002573183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist