Provider Demographics
NPI:1801077052
Name:CHAAR, SAM Z (RPH)
Entity type:Individual
Prefix:
First Name:SAM
Middle Name:Z
Last Name:CHAAR
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8338 WARBLER WAY
Mailing Address - Street 2:
Mailing Address - City:LIVERPOOL
Mailing Address - State:NY
Mailing Address - Zip Code:13090-1030
Mailing Address - Country:US
Mailing Address - Phone:315-622-0785
Mailing Address - Fax:
Practice Address - Street 1:110 E BROADWAY
Practice Address - Street 2:
Practice Address - City:FULTON
Practice Address - State:NY
Practice Address - Zip Code:13069-2300
Practice Address - Country:US
Practice Address - Phone:315-598-2380
Practice Address - Fax:315-598-3741
Is Sole Proprietor?:Yes
Enumeration Date:2007-11-15
Last Update Date:2007-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY039208183500000X
FL24503183500000X
NJ28RI02990900183500000X
AZ14675183500000X
TX43213183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist