Healthcare Provider Details

I. General information

NPI: 1346020054
Provider Name (Legal Business Name): SARAH PAGE GEBOW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/02/2023
Last Update Date: 10/02/2023
Certification Date: 09/30/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

201 JOHN E DEVINE DR
MANCHESTER NH
03103-4034
US

IV. Provider business mailing address

27 HOUDE ST
NASHUA NH
03060-3011
US

V. Phone/Fax

Practice location:
  • Phone: 603-626-1233
  • Fax:
Mailing address:
  • Phone: 978-382-2081
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberPHCY-01540
License Number StateNH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: