Healthcare Provider Details

I. General information

NPI: 1477036184
Provider Name (Legal Business Name): SARAH P BANDAY RPH
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/09/2018
Last Update Date: 09/09/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3922 WILLIS AVE
LOUISVILLE KY
40207-4911
US

IV. Provider business mailing address

7814 FARM SPRING DR
PROSPECT KY
40059-7610
US

V. Phone/Fax

Practice location:
  • Phone: 502-690-4462
  • Fax:
Mailing address:
  • Phone: 502-619-9650
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number020189
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: