Provider Demographics
NPI:1679354419
Name:ZAMORA, SARAH ANN (PHARMD)
Entity Type:Individual
Prefix:
First Name:SARAH
Middle Name:ANN
Last Name:ZAMORA
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 1:4319 167TH AVE NE
Mailing Address - Street 2:
Mailing Address - City:HAM LAKE
Mailing Address - State:MN
Mailing Address - Zip Code:55304-5229
Mailing Address - Country:US
Mailing Address - Phone:612-481-4135
Mailing Address - Fax:
Practice Address - Street 1:4319 167TH AVE NE
Practice Address - Street 2:
Practice Address - City:HAM LAKE
Practice Address - State:MN
Practice Address - Zip Code:55304-5229
Practice Address - Country:US
Practice Address - Phone:612-481-4135
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-10-09
Last Update Date:2023-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN1240781835P0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P0200XPharmacy Service ProvidersPharmacistPediatrics