Provider Demographics
NPI:1912230616
Name:CONSTANTIAN, SARA K (RPH)
Entity Type:Individual
Prefix:
First Name:SARA
Middle Name:K
Last Name:CONSTANTIAN
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13422 CLIFFHAVEN LN
Mailing Address - Street 2:
Mailing Address - City:HUNTERSVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28078-7740
Mailing Address - Country:US
Mailing Address - Phone:704-582-3320
Mailing Address - Fax:
Practice Address - Street 1:16711 BIRKDALE CMNS PKWY
Practice Address - Street 2:
Practice Address - City:HUNTERSVILLE
Practice Address - State:NC
Practice Address - Zip Code:28078-4412
Practice Address - Country:US
Practice Address - Phone:704-894-9781
Practice Address - Fax:704-894-9817
Is Sole Proprietor?:Yes
Enumeration Date:2009-09-12
Last Update Date:2009-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC9384183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist