Provider Demographics
NPI:1821690702
Name:SAKELARIOS, MICHAEL (BS, PHARMACIST)
Entity Type:Individual
Prefix:
First Name:MICHAEL
Middle Name:
Last Name:SAKELARIOS
Suffix:
Gender:M
Credentials:BS, PHARMACIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:21 MCINTOSH LN
Mailing Address - Street 2:
Mailing Address - City:BEDFORD
Mailing Address - State:NH
Mailing Address - Zip Code:03110-4417
Mailing Address - Country:US
Mailing Address - Phone:603-471-0638
Mailing Address - Fax:603-497-3232
Practice Address - Street 1:577 MAST RD
Practice Address - Street 2:
Practice Address - City:MANCHESTER
Practice Address - State:NH
Practice Address - Zip Code:03102-1157
Practice Address - Country:US
Practice Address - Phone:603-623-3290
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-11-15
Last Update Date:2020-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH2074183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist