Provider Demographics
NPI:1972182400
Name:SANDERS, BROOKE ELLEN (PHARMD)
Entity Type:Individual
Prefix:
First Name:BROOKE
Middle Name:ELLEN
Last Name:SANDERS
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 1:334 KLAMATH DR
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15205-5206
Mailing Address - Country:US
Mailing Address - Phone:412-526-6247
Mailing Address - Fax:
Practice Address - Street 1:2100 WASHINGTON PIKE
Practice Address - Street 2:
Practice Address - City:CARNEGIE
Practice Address - State:PA
Practice Address - Zip Code:15106-3751
Practice Address - Country:US
Practice Address - Phone:412-276-7077
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-04-02
Last Update Date:2021-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARP453969183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist