Provider Demographics
NPI:1558674770
Name:SAWYER, KEVIN W (RPH)
Entity Type:Individual
Prefix:
First Name:KEVIN
Middle Name:W
Last Name:SAWYER
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:348 WINCHESTER ST
Mailing Address - Street 2:RITEAID PHARMACY 10284
Mailing Address - City:KEENE
Mailing Address - State:NH
Mailing Address - Zip Code:03431-3936
Mailing Address - Country:US
Mailing Address - Phone:603-352-6969
Mailing Address - Fax:603-352-7936
Practice Address - Street 1:348 WINCHESTER ST
Practice Address - Street 2:RITEAID PHARMACY 10284
Practice Address - City:KEENE
Practice Address - State:NH
Practice Address - Zip Code:03431-3936
Practice Address - Country:US
Practice Address - Phone:603-352-6969
Practice Address - Fax:603-352-7936
Is Sole Proprietor?:No
Enumeration Date:2010-07-16
Last Update Date:2010-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH2147183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist