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NPI Code Detail

MEDICARE: SARAH DIEBEL RPH

MEDICARE: SARAH DIEBEL 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
1183500000XPharmacist052685NY

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1052685OTHERNYPHARMACIST LICENSE #

General Provider Information

NPI Number : 1508189093
Entity Type Code : Individual
Provider Name (Legal Business Name) : SARAH DIEBEL RPH
Provider Business Mailing Address
First Line : 3177 LATTA RD
Second Line :
City : ROCHESTER
State : NY
Zip : 14612-3094
Country : US
Telephone Number : 585-225-6111
Fax Number : 585-723-6289
Provider Business Practice Location Address
First Line : 3177 LATTA RD
Second Line :
City : ROCHESTER
State : NY
Zip : 14612-3094
Country : US
Telephone Number : 585-225-6111
Fax Number : 585-723-6289
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/11/2010
Last Update Date : 03/11/2010

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