Provider Demographics
NPI:1689183659
Name:GILLIARD, SARAH ANN (PHARMD)
Entity Type:Individual
Prefix:
First Name:SARAH
Middle Name:ANN
Last Name:GILLIARD
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 1:201 WALTERSCHEID BLVD.
Mailing Address - Street 2:APT. #2-208
Mailing Address - City:CHEYENNE
Mailing Address - State:WY
Mailing Address - Zip Code:82007
Mailing Address - Country:US
Mailing Address - Phone:954-540-2937
Mailing Address - Fax:
Practice Address - Street 1:2300 CAPITAL AVENUE
Practice Address - Street 2:SUITE B27
Practice Address - City:CHEYENNE
Practice Address - State:WY
Practice Address - Zip Code:82002
Practice Address - Country:US
Practice Address - Phone:307-635-1297
Practice Address - Fax:307-635-2156
Is Sole Proprietor?:No
Enumeration Date:2017-09-21
Last Update Date:2019-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WY4000183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist