=====================================================
General NPI Number Information
=====================================================
NPI Number | 1851980742
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | SARAH ALBANESE PHARMD
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 01/14/2021
-----------------------------------------------------
Last Update Date | 01/14/2021
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 130 ELM ST
-----------------------------------------------------
City | LUDLOW
-----------------------------------------------------
State | KY
-----------------------------------------------------
Zip | 41016-1520
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 859-261-2210
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 125 COLLEGE PARK DR
-----------------------------------------------------
City | CRESTVIEW HILLS
-----------------------------------------------------
State | KY
-----------------------------------------------------
Zip | 41017-2566
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 859-750-2941
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 1835P2201X
-----------------------------------------------------
Taxonomy Name | Ambulatory Care Pharmacist
-----------------------------------------------------
License Number | 013749
-----------------------------------------------------
License Number State | KY
-----------------------------------------------------