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NPI Code Detail

MEDICARE: SARA BOLES PHARMD

MEDICARE: SARA BOLES PHARMD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1183500000XPharmacist43352TN

General Provider Information

NPI Number : 1013529171
Entity Type Code : Individual
Provider Name (Legal Business Name) : SARA BOLES PHARMD
Provider Business Mailing Address
First Line : 103 N SHADY ST
Second Line :
City : MOUNTAIN CITY
State : TN
Zip : 37683-1333
Country : US
Telephone Number : 423-727-5652
Fax Number :
Provider Business Practice Location Address
First Line : 103 N SHADY ST
Second Line :
City : MOUNTAIN CITY
State : TN
Zip : 37683-1333
Country : US
Telephone Number : 423-727-5652
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/20/2020
Last Update Date : 08/20/2020

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Directions to “ SARA BOLES PHARMD” Practice Location

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