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NPI 1497427728

NPI 1497427728 : SARAH CONNELLY PHARMD : CHARLOTTE, NC

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General NPI Number Information
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    NPI Number           |    1497427728
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    Entity Type          |    Individual 
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    Provider Name        |    SARAH CONNELLY PHARMD
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    10/05/2021
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    Last Update Date     |    10/05/2021
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Provider Practice Location Address
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    Address Line         |    210 E TRADE ST STE E186 
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    City                 |    CHARLOTTE
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    State                |    NC
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    Zip                  |    28202-2355
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    Country              |    US
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    Telephone            |    704-971-1254
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    210 E TRADE ST STE 186 
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    City                 |    CHARLOTTE
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    State                |    NC
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    Zip                  |    28202-2413
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    Country              |    US
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    Telephone            |    
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    Fax                  |    
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Authorized Official
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    Title or Position    |    
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    Name                 |        
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    Credential           |    
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    Telephone            |    
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    183500000X
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    Taxonomy Name        |    Pharmacist
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    License Number       |    69151
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    License Number State |    TX
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Taxonomy #2
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    Taxonomy Code        |    183500000X
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    Taxonomy Name        |    Pharmacist
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    License Number       |    30836
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    License Number State |    NC
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