Provider Demographics
NPI:1881240463
Name:MERCANTE, SARAH (PST023106)
Entity type:Individual
Prefix:MS
First Name:SARAH
Middle Name:
Last Name:MERCANTE
Suffix:
Gender:F
Credentials:PST023106
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:41196 N HOOVER RD
Mailing Address - Street 2:
Mailing Address - City:PONCHATOULA
Mailing Address - State:LA
Mailing Address - Zip Code:70454-4422
Mailing Address - Country:US
Mailing Address - Phone:985-981-6978
Mailing Address - Fax:
Practice Address - Street 1:19008 HIGHWAY 22
Practice Address - Street 2:
Practice Address - City:PONCHATOULA
Practice Address - State:LA
Practice Address - Zip Code:70454-6780
Practice Address - Country:US
Practice Address - Phone:985-386-6556
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-08-10
Last Update Date:2019-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAPST.023106183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist