MEDICARE: SARA GREEN RPH

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
1	183500000X	Pharmacist	39881	TX

General Provider Information

NPI Number	:	1134717192
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SARA GREEN RPH

Provider Business Mailing Address
First Line	:	2701 LAKESEDGE DR
Second Line	:
City	:	MCKINNEY
State	:	TX
Zip	:	75072-3954
Country	:	US
Telephone Number	:	214-578-4052
Fax Number	:

Provider Business Practice Location Address
First Line	:	6100 ELDORADO PKWY
Second Line	:
City	:	MCKINNEY
State	:	TX
Zip	:	75070-5622
Country	:	US
Telephone Number	:	972-548-5140
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/05/2021
Last Update Date	:	01/05/2021

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Directions to “ SARA GREEN RPH” Practice Location

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