Provider Demographics
NPI:1477500478
Name:DUGAN, SARA ELAINE (PHARMD, BCPP)
Entity Type:Individual
Prefix:DR
First Name:SARA
Middle Name:ELAINE
Last Name:DUGAN
Suffix:
Gender:F
Credentials:PHARMD, BCPP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4209 STATE ROUTE 44
Mailing Address - Street 2:PO BOX 95
Mailing Address - City:ROOTSTOWN
Mailing Address - State:OH
Mailing Address - Zip Code:44272-9698
Mailing Address - Country:US
Mailing Address - Phone:330-325-6119
Mailing Address - Fax:330-325-5951
Practice Address - Street 1:4209 STATE ROUTE 44
Practice Address - Street 2:
Practice Address - City:ROOTSTOWN
Practice Address - State:OH
Practice Address - Zip Code:44272-9698
Practice Address - Country:US
Practice Address - Phone:330-325-6119
Practice Address - Fax:330-325-5951
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-27
Last Update Date:2012-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY20 050212183500000X, 1835P1300X
OH03-1-256551835P1300X, 183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P1300XPharmacy Service ProvidersPharmacistPsychiatric
No183500000XPharmacy Service ProvidersPharmacist