Provider Demographics
NPI:1457861866
Name:EGGERS RUSSELL, SARAH LYNN (PHARMD, BCACP, CPP)
Entity Type:Individual
Prefix:
First Name:SARAH
Middle Name:LYNN
Last Name:EGGERS RUSSELL
Suffix:
Gender:F
Credentials:PHARMD, BCACP, CPP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2076 NC HIGHWAY 42 W STE 100
Mailing Address - Street 2:
Mailing Address - City:CLAYTON
Mailing Address - State:NC
Mailing Address - Zip Code:27520-5303
Mailing Address - Country:US
Mailing Address - Phone:984-215-3968
Mailing Address - Fax:919-359-0326
Practice Address - Street 1:1501 W CUMBERLAND ST
Practice Address - Street 2:
Practice Address - City:DUNN
Practice Address - State:NC
Practice Address - Zip Code:28334-4505
Practice Address - Country:US
Practice Address - Phone:828-773-7955
Practice Address - Fax:828-773-7955
Is Sole Proprietor?:No
Enumeration Date:2017-10-11
Last Update Date:2023-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC26978183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist