Healthcare Provider Details

I. General information

NPI: 1952755845
Provider Name (Legal Business Name): SARAH ROSE NESS PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/18/2016
Last Update Date: 04/18/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

30 MAIN ST W
HAZEN ND
58545-4205
US

IV. Provider business mailing address

3561 DRAKE DR N
COLEHARBOR ND
58531-3102
US

V. Phone/Fax

Practice location:
  • Phone: 701-748-2312
  • Fax: 701-748-2637
Mailing address:
  • Phone: 701-442-5308
  • Fax: 701-748-2637

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberRPH5603
License Number StateND

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: