Provider Demographics
NPI:1154685782
Name:MOLLOHAN, SARAH (PHARMD)
Entity Type:Individual
Prefix:
First Name:SARAH
Middle Name:
Last Name:MOLLOHAN
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16600 HIGHLANDS CENTER BLVD
Mailing Address - Street 2:TARGET PHARMACY T-2308
Mailing Address - City:BRISTOL
Mailing Address - State:VA
Mailing Address - Zip Code:24202-4301
Mailing Address - Country:US
Mailing Address - Phone:276-642-6301
Mailing Address - Fax:
Practice Address - Street 1:16600 HIGHLANDS CENTER BLVD
Practice Address - Street 2:TARGET PHARMACY T-2308
Practice Address - City:BRISTOL
Practice Address - State:VA
Practice Address - Zip Code:24202-4301
Practice Address - Country:US
Practice Address - Phone:276-642-6301
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-06-28
Last Update Date:2012-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0202211440183500000X
TN36739183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist