Provider Demographics
NPI:1346742780
Name:MCDONALD, SARA L (RPH)
Entity Type:Individual
Prefix:
First Name:SARA
Middle Name:L
Last Name:MCDONALD
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:SARA
Other - Middle Name:L
Other - Last Name:NELSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RPH
Mailing Address - Street 1:8111 MT HIGHWAY 35
Mailing Address - Street 2:
Mailing Address - City:BIGFORK
Mailing Address - State:MT
Mailing Address - Zip Code:59911-3588
Mailing Address - Country:US
Mailing Address - Phone:406-837-4370
Mailing Address - Fax:406-837-4390
Practice Address - Street 1:8111 MT HIGHWAY 35
Practice Address - Street 2:
Practice Address - City:BIGFORK
Practice Address - State:MT
Practice Address - Zip Code:59911-3588
Practice Address - Country:US
Practice Address - Phone:406-837-4370
Practice Address - Fax:406-837-4390
Is Sole Proprietor?:No
Enumeration Date:2018-03-01
Last Update Date:2018-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MTPHA-PHA-LIC-3647183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist