Provider Demographics
NPI:1164135901
Name:SUMNER, SABRINA DEAN (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:SABRINA
Middle Name:DEAN
Last Name:SUMNER
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 1:1161 E DAYTON YELLOW SPRINGS RD
Mailing Address - Street 2:
Mailing Address - City:FAIRBORN
Mailing Address - State:OH
Mailing Address - Zip Code:45324-6325
Mailing Address - Country:US
Mailing Address - Phone:937-318-3920
Mailing Address - Fax:
Practice Address - Street 1:1161 E DAYTON YELLOW SPRINGS RD
Practice Address - Street 2:
Practice Address - City:FAIRBORN
Practice Address - State:OH
Practice Address - Zip Code:45324-6325
Practice Address - Country:US
Practice Address - Phone:937-318-3920
Practice Address - Fax:937-318-3921
Is Sole Proprietor?:No
Enumeration Date:2022-12-26
Last Update Date:2022-12-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH03441407183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH03441407OtherOHIO BOARD OF PHARMACY LICENSE NUMBER