Provider Demographics
NPI:1821325655
Name:PROVIDENCE, SARAH MARIE (PHARMD)
Entity Type:Individual
Prefix:
First Name:SARAH
Middle Name:MARIE
Last Name:PROVIDENCE
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:UNIVERSITY DRIVE C
Mailing Address - Street 2:VA PITTSBURGH HEALTHCARE SYSTEM
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15240
Mailing Address - Country:US
Mailing Address - Phone:412-360-3423
Mailing Address - Fax:412-360-6193
Practice Address - Street 1:UNIVERSITY DRIVE C
Practice Address - Street 2:132M-U
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15240-1003
Practice Address - Country:US
Practice Address - Phone:412-360-3423
Practice Address - Fax:412-360-6193
Is Sole Proprietor?:No
Enumeration Date:2009-11-16
Last Update Date:2022-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARP4435541835C0205X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835C0205XPharmacy Service ProvidersPharmacistCritical Care