Provider Demographics
NPI:1174665764
Name:HASTINGS, SARAH ANNE (PHARM D)
Entity Type:Individual
Prefix:
First Name:SARAH
Middle Name:ANNE
Last Name:HASTINGS
Suffix:
Gender:F
Credentials:PHARM D
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 124
Mailing Address - Street 2:4315 MAIN ST
Mailing Address - City:PORT HENRY
Mailing Address - State:NY
Mailing Address - Zip Code:12974-0124
Mailing Address - Country:US
Mailing Address - Phone:518-546-7280
Mailing Address - Fax:
Practice Address - Street 1:4315 MAIN ST
Practice Address - Street 2:
Practice Address - City:PORT HENRY
Practice Address - State:NY
Practice Address - Zip Code:12974-1339
Practice Address - Country:US
Practice Address - Phone:518-546-7244
Practice Address - Fax:518-546-9722
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY051109183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist