Provider Demographics
NPI:1417073230
Name:SARTIN, HELEN LORRAINE (CPHT)
Entity Type:Individual
Prefix:MRS
First Name:HELEN
Middle Name:LORRAINE
Last Name:SARTIN
Suffix:
Gender:F
Credentials:CPHT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4937 OAKFIELD CIR
Mailing Address - Street 2:
Mailing Address - City:DADE CITY
Mailing Address - State:FL
Mailing Address - Zip Code:33523-9135
Mailing Address - Country:US
Mailing Address - Phone:352-583-9420
Mailing Address - Fax:
Practice Address - Street 1:7305 BROAD ST
Practice Address - Street 2:WAL-MART
Practice Address - City:BROOKSVILLE
Practice Address - State:FL
Practice Address - Zip Code:34602-7548
Practice Address - Country:US
Practice Address - Phone:352-796-6221
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-22
Last Update Date:2013-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL183700000X183700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183700000XPharmacy Service ProvidersPharmacy Technician
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL103317400Medicaid
FLPH15421OtherLICENSE NUMBER