Healthcare Provider Details

I. General information

NPI: 1417762923
Provider Name (Legal Business Name): SARA ELIZABETH BLISS PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/11/2025
Last Update Date: 02/11/2025
Certification Date: 02/11/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

101 MANNING DR
CHAPEL HILL NC
27514-4226
US

IV. Provider business mailing address

101 MANNING DR
CHAPEL HILL NC
27514-4226
US

V. Phone/Fax

Practice location:
  • Phone: 849-740-2239
  • Fax:
Mailing address:
  • Phone: 849-974-0223
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835N1003X
TaxonomyNutrition Support Pharmacist
License Number22884
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: