MEDICARE: SARA JEANNE PUTERBAUGH R.PH.

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	1835P0018X	Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist	03-2-17849	OH

General Provider Information

NPI Number	:	1841401601
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SARA JEANNE PUTERBAUGH R.PH.

Provider Business Mailing Address
First Line	:	17518 IDA CENTER RD
Second Line	:
City	:	PETERSBURG
State	:	MI
Zip	:	49270-9749
Country	:	US
Telephone Number	:	419-690-6676
Fax Number	:

Provider Business Practice Location Address
First Line	:	833 W ALEXIS RD
Second Line	:
City	:	TOLEDO
State	:	OH
Zip	:	43612-4303
Country	:	US
Telephone Number	:	419-269-6909
Fax Number	:	419-269-6911

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

Provider Enumeration Date	:	05/24/2007
Last Update Date	:	06/22/2026

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