Provider Demographics
NPI:1659658847
Name:LALIBERTE, SARAH RUTH (PHARMD)
Entity type:Individual
Prefix:
First Name:SARAH
Middle Name:RUTH
Last Name:LALIBERTE
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 1:2128 PINNACLE TERRACE WAY
Mailing Address - Street 2:APARTMENT 204
Mailing Address - City:COTTONWOOD HEIGHTS
Mailing Address - State:UT
Mailing Address - Zip Code:84121
Mailing Address - Country:US
Mailing Address - Phone:802-236-0359
Mailing Address - Fax:
Practice Address - Street 1:2330 FORT UNION BLVD
Practice Address - Street 2:
Practice Address - City:COTTONWOOD HEIGHTS
Practice Address - State:UT
Practice Address - Zip Code:84121-3339
Practice Address - Country:US
Practice Address - Phone:801-308-1013
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-11-16
Last Update Date:2011-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT6651400-1701183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist