Provider Demographics
NPI:1982708517
Name:PRICE, SARAH ELISA (PHARMD)
Entity Type:Individual
Prefix:MRS
First Name:SARAH
Middle Name:ELISA
Last Name:PRICE
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 1:7848 PETERSEN POINT RD
Mailing Address - Street 2:
Mailing Address - City:MILTON
Mailing Address - State:FL
Mailing Address - Zip Code:32583-8543
Mailing Address - Country:US
Mailing Address - Phone:850-686-5361
Mailing Address - Fax:
Practice Address - Street 1:6050 HIGHWAY 90
Practice Address - Street 2:KMART PHARMACY #3975
Practice Address - City:MILTON
Practice Address - State:FL
Practice Address - Zip Code:32570-1703
Practice Address - Country:US
Practice Address - Phone:850-623-6604
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-09-12
Last Update Date:2015-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS38813183500000X
GARPH022339183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist