Provider Demographics
NPI:1689846743
Name:SAXAGNE, BETH ANN (PHARMD)
Entity Type:Individual
Prefix:
First Name:BETH ANN
Middle Name:
Last Name:SAXAGNE
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 1:25 STATE ROUTE 39
Mailing Address - Street 2:PHARMACY DEPARTMENT
Mailing Address - City:NEW FAIRFIELD
Mailing Address - State:CT
Mailing Address - Zip Code:06812-4044
Mailing Address - Country:US
Mailing Address - Phone:203-312-9818
Mailing Address - Fax:203-312-9830
Practice Address - Street 1:25 STATE ROUTE 39
Practice Address - Street 2:PHARMACY DEPARTMENT
Practice Address - City:NEW FAIRFIELD
Practice Address - State:CT
Practice Address - Zip Code:06812-4044
Practice Address - Country:US
Practice Address - Phone:203-312-9818
Practice Address - Fax:203-312-9830
Is Sole Proprietor?:No
Enumeration Date:2008-03-29
Last Update Date:2008-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT10853183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist