Provider Demographics
NPI:1194456673
Name:MILLER, SARAH WILLIAMS
Entity Type:Individual
Prefix:
First Name:SARAH
Middle Name:WILLIAMS
Last Name:MILLER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2530 VERNON AVE
Mailing Address - Street 2:
Mailing Address - City:WINTERVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28590-9543
Mailing Address - Country:US
Mailing Address - Phone:910-358-3664
Mailing Address - Fax:
Practice Address - Street 1:3754 S MAIN ST
Practice Address - Street 2:
Practice Address - City:FARMVILLE
Practice Address - State:NC
Practice Address - Zip Code:27828-8546
Practice Address - Country:US
Practice Address - Phone:252-787-5990
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-06-23
Last Update Date:2022-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC31319183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist