Provider Demographics
NPI:1255972576
Name:BRAGA, SARAH FOWLER (PHARMD)
Entity type:Individual
Prefix:
First Name:SARAH
Middle Name:FOWLER
Last Name:BRAGA
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 1:127 MARITIME TRL
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:SC
Mailing Address - Zip Code:29072-9675
Mailing Address - Country:US
Mailing Address - Phone:803-414-9252
Mailing Address - Fax:
Practice Address - Street 1:10 SCIENCE CT
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:SC
Practice Address - Zip Code:29203-9344
Practice Address - Country:US
Practice Address - Phone:803-935-9717
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-10-08
Last Update Date:2019-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC6574183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist