Provider Demographics
NPI:1194867598
Name:BOSS-ISENHOUR, SARA ELLEN (RPH)
Entity Type:Individual
Prefix:MRS
First Name:SARA
Middle Name:ELLEN
Last Name:BOSS-ISENHOUR
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 1:406 6TH ST NW
Mailing Address - Street 2:
Mailing Address - City:HICKORY
Mailing Address - State:NC
Mailing Address - Zip Code:28601-3502
Mailing Address - Country:US
Mailing Address - Phone:828-327-2834
Mailing Address - Fax:828-327-6003
Practice Address - Street 1:1501 TATE BLVD SE
Practice Address - Street 2:SUITE 102
Practice Address - City:HICKORY
Practice Address - State:NC
Practice Address - Zip Code:28602-1384
Practice Address - Country:US
Practice Address - Phone:828-324-4630
Practice Address - Fax:828-324-4675
Is Sole Proprietor?:No
Enumeration Date:2007-02-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC6657183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist