Provider Demographics
NPI:1629691381
Name:WILLIFORD, SARAH ELAINE (PHARMD)
Entity Type:Individual
Prefix:
First Name:SARAH
Middle Name:ELAINE
Last Name:WILLIFORD
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2561 COUNTY ROAD 220 STE 308
Mailing Address - Street 2:
Mailing Address - City:MIDDLEBURG
Mailing Address - State:FL
Mailing Address - Zip Code:32068-8518
Mailing Address - Country:US
Mailing Address - Phone:904-375-8579
Mailing Address - Fax:904-375-8581
Practice Address - Street 1:2561 COUNTY ROAD 220 STE 308
Practice Address - Street 2:
Practice Address - City:MIDDLEBURG
Practice Address - State:FL
Practice Address - Zip Code:32068-8518
Practice Address - Country:US
Practice Address - Phone:904-375-8579
Practice Address - Fax:904-375-8581
Is Sole Proprietor?:No
Enumeration Date:2020-05-28
Last Update Date:2020-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS54247183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist