Healthcare Provider Details

I. General information

NPI: 1154555936
Provider Name (Legal Business Name): SARAH JANE BRATT RPH
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: SARAH JANE PAKULSKI RPH

II. Dates (important events)

Enumeration Date: 05/08/2009
Last Update Date: 05/08/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3362 NAVARRE AVE
OREGON OH
43616-3314
US

IV. Provider business mailing address

3362 NAVARRE AVE
OREGON OH
43616-3314
US

V. Phone/Fax

Practice location:
  • Phone: 419-690-8269
  • Fax: 419-690-8284
Mailing address:
  • Phone: 419-690-8269
  • Fax: 419-690-8284

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number03321835
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: