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NPI Code Detail

MEDICARE: DR. SARAH DANIELLE WYLIE PHARMD

MEDICARE: DR. SARAH DANIELLE WYLIE 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
1183500000XPharmacist20471NC

General Provider Information

NPI Number : 1790011070
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. SARAH DANIELLE WYLIE PHARMD
Provider Business Mailing Address
First Line : 2202 WAYNE MEMORIAL DR
Second Line :
City : GOLDSBORO
State : NC
Zip : 27534-1724
Country : US
Telephone Number : 919-739-5539
Fax Number : 919-736-9573
Provider Business Practice Location Address
First Line : 2202 WAYNE MEMORIAL DR
Second Line :
City : GOLDSBORO
State : NC
Zip : 27534-1724
Country : US
Telephone Number : 919-739-5539
Fax Number : 919-736-9573
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/21/2009
Last Update Date : 10/21/2009

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