Provider Demographics
NPI:1689122095
Name:FAULKINGHAM, SARAH (PHARMD)
Entity Type:Individual
Prefix:
First Name:SARAH
Middle Name:
Last Name:FAULKINGHAM
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 1:28 MAXWELL RD
Mailing Address - Street 2:
Mailing Address - City:BIRCH HARBOR
Mailing Address - State:ME
Mailing Address - Zip Code:04613
Mailing Address - Country:US
Mailing Address - Phone:207-702-5084
Mailing Address - Fax:
Practice Address - Street 1:28 MAXWELL RD
Practice Address - Street 2:
Practice Address - City:BIRCH HARBOR
Practice Address - State:ME
Practice Address - Zip Code:04613
Practice Address - Country:US
Practice Address - Phone:207-702-5084
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-09-14
Last Update Date:2016-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MEPR453451835P1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P1200XPharmacy Service ProvidersPharmacistPharmacotherapy