Provider Demographics
NPI:1497393730
Name:BREWER, SARAH JOY (RPH)
Entity Type:Individual
Prefix:
First Name:SARAH
Middle Name:JOY
Last Name:BREWER
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 1:126 CARRINGTON DR
Mailing Address - Street 2:
Mailing Address - City:MADISON
Mailing Address - State:MS
Mailing Address - Zip Code:39110-6889
Mailing Address - Country:US
Mailing Address - Phone:601-624-4515
Mailing Address - Fax:
Practice Address - Street 1:1070 HIGHWAY 51
Practice Address - Street 2:
Practice Address - City:MADISON
Practice Address - State:MS
Practice Address - Zip Code:39110-9084
Practice Address - Country:US
Practice Address - Phone:601-856-3275
Practice Address - Fax:601-853-6203
Is Sole Proprietor?:No
Enumeration Date:2019-12-17
Last Update Date:2020-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MSE08119183500000X
MSE-81191835P0018X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P0018XPharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
No183500000XPharmacy Service ProvidersPharmacist