Provider Demographics
NPI:1134655038
Name:KOTSCHWAR, SARA ANN (PHARM D)
Entity Type:Individual
Prefix:DR
First Name:SARA
Middle Name:ANN
Last Name:KOTSCHWAR
Suffix:
Gender:F
Credentials:PHARM D
Other - Prefix:DR
Other - First Name:SARA
Other - Middle Name:ANN
Other - Last Name:FREDERICKS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PHARM D
Mailing Address - Street 1:10150 CLEAR CREEK RD
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80920-1439
Mailing Address - Country:US
Mailing Address - Phone:719-641-8897
Mailing Address - Fax:
Practice Address - Street 1:10150 CLEAR CREEK RD
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80920-1439
Practice Address - Country:US
Practice Address - Phone:719-641-8897
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-05-11
Last Update Date:2017-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COPHA.0016778183500000X
NE11861183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist