Healthcare Provider Details

I. General information

NPI: 1568388593
Provider Name (Legal Business Name): SARA ELIZABETH BOSEK
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/24/2026
Last Update Date: 06/24/2026
Certification Date: 06/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

30 MEDICINE CIRCLE CLINIC 1A
DURHAM NC
27710-0001
US

IV. Provider business mailing address

6430 ENGLISH OAKS DR
RALEIGH NC
27615-6322
US

V. Phone/Fax

Practice location:
  • Phone: 919-668-5360
  • Fax: 919-684-5743
Mailing address:
  • Phone: 813-928-3701
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835P0018X
TaxonomyPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
License Number33132
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: