Provider Demographics
NPI:1417089673
Name:HUYCK, SARAH JUDE (PHARMD)
Entity Type:Individual
Prefix:
First Name:SARAH
Middle Name:JUDE
Last Name:HUYCK
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 1:2300 BEAVER AVE APT 2
Mailing Address - Street 2:
Mailing Address - City:DES MOINES
Mailing Address - State:IA
Mailing Address - Zip Code:50310-3901
Mailing Address - Country:US
Mailing Address - Phone:402-960-7247
Mailing Address - Fax:
Practice Address - Street 1:1320 E EUCLID AVE
Practice Address - Street 2:
Practice Address - City:DES MOINES
Practice Address - State:IA
Practice Address - Zip Code:50316-1205
Practice Address - Country:US
Practice Address - Phone:515-265-5946
Practice Address - Fax:515-264-8344
Is Sole Proprietor?:No
Enumeration Date:2007-03-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA20415183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist