Healthcare Provider Details

I. General information

NPI: 1255677993
Provider Name (Legal Business Name): SARAH MARIE KRISH PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/28/2012
Last Update Date: 04/20/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2055 WEDGEFIELD RD
SUMTER SC
29154-4654
US

IV. Provider business mailing address

316 W HAMPTON AVE
SUMTER SC
29150-4922
US

V. Phone/Fax

Practice location:
  • Phone: 803-773-5979
  • Fax: 803-773-6088
Mailing address:
  • Phone: 803-795-8650
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number12173
License Number StateSC
# 2
Primary TaxonomyN
Taxonomy Code1835N0905X
TaxonomyNuclear Pharmacist
License Number12173
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: