Healthcare Provider Details

I. General information

NPI: 1174665764
Provider Name (Legal Business Name): SARAH ANNE HASTINGS PHARM D
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/12/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4315 MAIN ST
PORT HENRY NY
12974-1339
US

IV. Provider business mailing address

PO BOX 124 4315 MAIN ST
PORT HENRY NY
12974-0124
US

V. Phone/Fax

Practice location:
  • Phone: 518-546-7244
  • Fax: 518-546-9722
Mailing address:
  • Phone: 518-546-7280
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number051109
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: