Healthcare Provider Details

I. General information

NPI: 1437747979
Provider Name (Legal Business Name): SARAH A ELJAOUNI
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/08/2021
Last Update Date: 01/08/2021
Certification Date: 01/08/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5401 ABERCORN ST
SAVANNAH GA
31405-6901
US

IV. Provider business mailing address

5401 ABERCORN ST
SAVANNAH GA
31405-6901
US

V. Phone/Fax

Practice location:
  • Phone: 912-356-3170
  • Fax:
Mailing address:
  • Phone: 912-356-3170
  • Fax: 912-355-3807

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberPHI-021647
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: