Provider Demographics
NPI:1811477672
Name:SANDERS, LAUREN JAE (PHARMD)
Entity type:Individual
Prefix:
First Name:LAUREN
Middle Name:JAE
Last Name:SANDERS
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 1:8235 S PECAN GROVE CIR
Mailing Address - Street 2:
Mailing Address - City:TEMPE
Mailing Address - State:AZ
Mailing Address - Zip Code:85284-2311
Mailing Address - Country:US
Mailing Address - Phone:602-300-5552
Mailing Address - Fax:
Practice Address - Street 1:3838 N CAMPBELL AVE
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85719-1478
Practice Address - Country:US
Practice Address - Phone:520-694-0399
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-08-20
Last Update Date:2018-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZS0234971835X0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835X0200XPharmacy Service ProvidersPharmacistOncology