Provider Demographics
NPI:1922382639
Name:THORNTON, SARAH RAUTH (PHARMD)
Entity Type:Individual
Prefix:
First Name:SARAH
Middle Name:RAUTH
Last Name:THORNTON
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:SARAH
Other - Middle Name:
Other - Last Name:RAUTH
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:PHARMD
Mailing Address - Street 1:2200 N HIGHWAY A1A
Mailing Address - Street 2:
Mailing Address - City:MELBOURNE
Mailing Address - State:FL
Mailing Address - Zip Code:32903-2511
Mailing Address - Country:US
Mailing Address - Phone:321-773-2022
Mailing Address - Fax:
Practice Address - Street 1:2200 N HIGHWAY A1A
Practice Address - Street 2:
Practice Address - City:MELBOURNE
Practice Address - State:FL
Practice Address - Zip Code:32903-2511
Practice Address - Country:US
Practice Address - Phone:321-773-2022
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-09-30
Last Update Date:2011-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS47582183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist