Provider Demographics
NPI:1396380374
Name:CASSADY, SARAH MILLICENT (PHARMD)
Entity Type:Individual
Prefix:
First Name:SARAH
Middle Name:MILLICENT
Last Name:CASSADY
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1209 S COLLEGE ST UNIT 2209
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28203-4584
Mailing Address - Country:US
Mailing Address - Phone:251-223-1212
Mailing Address - Fax:
Practice Address - Street 1:2115 BEATTIES FORD RD
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28216-4307
Practice Address - Country:US
Practice Address - Phone:704-394-5026
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-11-13
Last Update Date:2019-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC29153183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist