MEDICARE: SARA ANN WHITE 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	5868783-1701	UT

General Provider Information

NPI Number	:	1528779535
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SARA ANN WHITE PHARM.D.

Provider Business Mailing Address
First Line	:	4515 S 900 E
Second Line	:
City	:	SALT LAKE CITY
State	:	UT
Zip	:	84117-4101
Country	:	US
Telephone Number	:	801-266-1215
Fax Number	:	801-266-3010

Provider Business Practice Location Address
First Line	:	4515 S 900 E
Second Line	:
City	:	SALT LAKE CITY
State	:	UT
Zip	:	84117-4101
Country	:	US
Telephone Number	:	801-266-1215
Fax Number	:

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

Provider Enumeration Date	:	12/09/2022
Last Update Date	:	12/09/2022

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