MEDICARE: DR. SARAH L MALLAK PHARM.D.

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	MN119774	MN

General Provider Information

NPI Number	:	1205103207
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. SARAH L MALLAK PHARM.D.

Provider Business Mailing Address
First Line	:	1 OPTUM CIR
Second Line	:
City	:	EDEN PRAIRIE
State	:	MN
Zip	:	55344-2956
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1 OPTUM CIR
Second Line	:
City	:	EDEN PRAIRIE
State	:	MN
Zip	:	55344-2956
Country	:	US
Telephone Number	:	800-519-1139
Fax Number	:

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

Provider Enumeration Date	:	11/19/2011
Last Update Date	:	12/11/2025

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