Provider Demographics
NPI:1326643131
Name:HARR, SASHA NICOLE
Entity Type:Individual
Prefix:
First Name:SASHA
Middle Name:NICOLE
Last Name:HARR
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 1:1331 YOUNGSTOWN WARREN RD
Mailing Address - Street 2:
Mailing Address - City:NILES
Mailing Address - State:OH
Mailing Address - Zip Code:44446-4616
Mailing Address - Country:US
Mailing Address - Phone:330-505-2601
Mailing Address - Fax:330-505-1069
Practice Address - Street 1:1331 YOUNGSTOWN WARREN RD
Practice Address - Street 2:
Practice Address - City:NILES
Practice Address - State:OH
Practice Address - Zip Code:44446-4616
Practice Address - Country:US
Practice Address - Phone:330-505-2601
Practice Address - Fax:330-505-1069
Is Sole Proprietor?:Yes
Enumeration Date:2020-12-01
Last Update Date:2020-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH03439267183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes183500000XPharmacy Service ProvidersPharmacistGroup - Single Specialty