Provider Demographics
NPI:1750660288
Name:MCCOY, SARA ANN (PHARMACY TECHNICIAN)
Entity Type:Individual
Prefix:MRS
First Name:SARA
Middle Name:ANN
Last Name:MCCOY
Suffix:
Gender:F
Credentials:PHARMACY TECHNICIAN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3751 S BERN RD
Mailing Address - Street 2:
Mailing Address - City:BAY CITY
Mailing Address - State:MI
Mailing Address - Zip Code:48706-9235
Mailing Address - Country:US
Mailing Address - Phone:989-443-1199
Mailing Address - Fax:
Practice Address - Street 1:205 SPRUCE ST
Practice Address - Street 2:
Practice Address - City:BAY CITY
Practice Address - State:MI
Practice Address - Zip Code:48706-3882
Practice Address - Country:US
Practice Address - Phone:989-316-5434
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-08-15
Last Update Date:2021-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5303032726183700000X
MI230014996500410374U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183700000XPharmacy Service ProvidersPharmacy Technician
No374U00000XNursing Service Related ProvidersHome Health Aide