Healthcare Provider Details

I. General information

NPI: 1629789292
Provider Name (Legal Business Name): SARAH SABAH
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/05/2022
Last Update Date: 05/19/2026
Certification Date: 05/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

45540 MICHIGAN AVE
CANTON MI
48188-2472
US

IV. Provider business mailing address

38821 COUNTRY CIR
FARMINGTON HILLS MI
48331-1016
US

V. Phone/Fax

Practice location:
  • Phone: 734-397-2560
  • Fax: 734-397-2691
Mailing address:
  • Phone: 586-569-6454
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835P0018X
TaxonomyPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
License Number5302414509
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: