Provider Demographics
NPI:1255160016
Name:SANOUSI, SARAH ELSIR (PHARMD)
Entity type:Individual
Prefix:
First Name:SARAH
Middle Name:ELSIR
Last Name:SANOUSI
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 1:8580 HIGHWAY 72 W
Mailing Address - Street 2:
Mailing Address - City:MADISON
Mailing Address - State:AL
Mailing Address - Zip Code:35758-9578
Mailing Address - Country:US
Mailing Address - Phone:256-716-6958
Mailing Address - Fax:
Practice Address - Street 1:8580 HIGHWAY 72 W
Practice Address - Street 2:
Practice Address - City:MADISON
Practice Address - State:AL
Practice Address - Zip Code:35758-9578
Practice Address - Country:US
Practice Address - Phone:256-716-6958
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-07-30
Last Update Date:2024-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL21632183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist