MEDICARE: SARA K JADI

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	183700000X	Pharmacy Technician	42235	NC

General Provider Information

NPI Number	:	1306236104
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SARA K JADI

Provider Business Mailing Address
First Line	:	204 HOLLY MOOR LN
Second Line	:
City	:	HOLLY SPRINGS
State	:	NC
Zip	:	27540-5959
Country	:	US
Telephone Number	:	240-899-2075
Fax Number	:

Provider Business Practice Location Address
First Line	:	100 GRAND HILL PL
Second Line	:
City	:	HOLLY SPRINGS
State	:	NC
Zip	:	27540-4416
Country	:	US
Telephone Number	:	919-762-3150
Fax Number	:

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

Provider Enumeration Date	:	01/31/2015
Last Update Date	:	01/31/2015

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Directions to “ SARA K JADI ” Practice Location

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