Provider Demographics
NPI:1730470931
Name:POTTER, SARAH SUSANNE (PHARMD, RPH)
Entity Type:Individual
Prefix:DR
First Name:SARAH
Middle Name:SUSANNE
Last Name:POTTER
Suffix:
Gender:F
Credentials:PHARMD, RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1559 BOOKER DAIRY RD
Mailing Address - Street 2:SUITE A
Mailing Address - City:SMITHFIELD
Mailing Address - State:NC
Mailing Address - Zip Code:27577-9441
Mailing Address - Country:US
Mailing Address - Phone:919-934-0694
Mailing Address - Fax:919-934-0044
Practice Address - Street 1:201 W VERNON AVE
Practice Address - Street 2:
Practice Address - City:KINSTON
Practice Address - State:NC
Practice Address - Zip Code:28501-3823
Practice Address - Country:US
Practice Address - Phone:252-527-7164
Practice Address - Fax:252-527-1152
Is Sole Proprietor?:No
Enumeration Date:2011-04-22
Last Update Date:2011-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC20310183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist