Healthcare Provider Details

I. General information

NPI: 1487578886
Provider Name (Legal Business Name): SARAH JANE MOORE PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/07/2026
Last Update Date: 08/07/2026
Certification Date: 08/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1950 WALES RD NE
MASSILLON OH
44646-4110
US

IV. Provider business mailing address

1595 KENYON AVE SW
MASSILLON OH
44647-9696
US

V. Phone/Fax

Practice location:
  • Phone: 330-833-5730
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number03447093
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: