Provider Demographics
NPI:1447585534
Name:HARTNETT, SALLIE J (RPH)
Entity Type:Individual
Prefix:
First Name:SALLIE
Middle Name:J
Last Name:HARTNETT
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8080 S HOUGHTON RD
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85747-9308
Mailing Address - Country:US
Mailing Address - Phone:520-663-1961
Mailing Address - Fax:520-663-1963
Practice Address - Street 1:8080 S HOUGHTON RD
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85747-9308
Practice Address - Country:US
Practice Address - Phone:520-663-1961
Practice Address - Fax:520-663-1963
Is Sole Proprietor?:Yes
Enumeration Date:2009-10-07
Last Update Date:2009-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ015215183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist