Provider Demographics
NPI:1982055539
Name:THOMPSON, SARA BOSKOVIC (PHARMD)
Entity Type:Individual
Prefix:
First Name:SARA
Middle Name:BOSKOVIC
Last Name:THOMPSON
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:SARA
Other - Middle Name:
Other - Last Name:BOSKOVIC
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1930 TRUMAN RD
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28205-3718
Mailing Address - Country:US
Mailing Address - Phone:919-360-6840
Mailing Address - Fax:
Practice Address - Street 1:1930 TRUMAN RD
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28205-3718
Practice Address - Country:US
Practice Address - Phone:919-360-6840
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-06-24
Last Update Date:2016-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC23359183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist