Provider Demographics
NPI:1164706016
Name:SANSONE, ANNAH (RPH)
Entity Type:Individual
Prefix:DR
First Name:ANNAH
Middle Name:
Last Name:SANSONE
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 1:525 S GREEN ST
Mailing Address - Street 2:
Mailing Address - City:BROWNSBURG
Mailing Address - State:IN
Mailing Address - Zip Code:46112-1608
Mailing Address - Country:US
Mailing Address - Phone:217-370-9216
Mailing Address - Fax:
Practice Address - Street 1:525 S GREEN ST
Practice Address - Street 2:
Practice Address - City:BROWNSBURG
Practice Address - State:IN
Practice Address - Zip Code:46112-1608
Practice Address - Country:US
Practice Address - Phone:217-370-9216
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-10-10
Last Update Date:2013-07-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVNV17430183500000X
IN26024973A183500000X
IL051295514183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist