Provider Demographics
NPI:1669002176
Name:TYLER, SARA DANIELLE (PHARMD)
Entity type:Individual
Prefix:
First Name:SARA
Middle Name:DANIELLE
Last Name:TYLER
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 1:439 WATERVIEW DR
Mailing Address - Street 2:
Mailing Address - City:WETUMPKA
Mailing Address - State:AL
Mailing Address - Zip Code:36092-7218
Mailing Address - Country:US
Mailing Address - Phone:334-300-3059
Mailing Address - Fax:
Practice Address - Street 1:439 WATERVIEW DR
Practice Address - Street 2:
Practice Address - City:WETUMPKA
Practice Address - State:AL
Practice Address - Zip Code:36092-7218
Practice Address - Country:US
Practice Address - Phone:334-300-3059
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-01-23
Last Update Date:2022-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL22463183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes183500000XPharmacy Service ProvidersPharmacistGroup - Multi-Specialty