MEDICARE: SARAH ELIZABETH SLONE PHARMD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	183500000X	Pharmacist	0202210091	VA

General Provider Information

NPI Number	:	1710277173
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SARAH ELIZABETH SLONE PHARMD

Provider Business Mailing Address
First Line	:	401 PENNSYLVANIA AVE
Second Line	:
City	:	BRISTOL
State	:	TN
Zip	:	37620-2323
Country	:	US
Telephone Number	:	423-573-3936
Fax Number	:

Provider Business Practice Location Address
First Line	:	16435 WISE STREET
Second Line	:
City	:	SAINT PAUL
State	:	VA
Zip	:	24283
Country	:	US
Telephone Number	:	276-762-5011
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/19/2011
Last Update Date	:	04/19/2011

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