Provider Demographics
NPI:1407504038
Name:O'CONNELL, SARA (PHARMD)
Entity Type:Individual
Prefix:
First Name:SARA
Middle Name:
Last Name:O'CONNELL
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:SARA
Other - Middle Name:
Other - Last Name:FITZENRIDER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PHARMD
Mailing Address - Street 1:6218 RIVERCLIFF LN
Mailing Address - Street 2:
Mailing Address - City:DAYTON
Mailing Address - State:OH
Mailing Address - Zip Code:45449-3048
Mailing Address - Country:US
Mailing Address - Phone:440-221-8389
Mailing Address - Fax:
Practice Address - Street 1:1575 LYONS RD
Practice Address - Street 2:
Practice Address - City:CENTERVILLE
Practice Address - State:OH
Practice Address - Zip Code:45458-1881
Practice Address - Country:US
Practice Address - Phone:937-439-9779
Practice Address - Fax:937-439-5443
Is Sole Proprietor?:Yes
Enumeration Date:2022-03-14
Last Update Date:2022-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH03328568183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist