MEDICARE: SARAH MARIE PROVIDENCE PHARMD

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	1835C0205X	Critical Care Pharmacist	RP443554	PA

General Provider Information

NPI Number	:	1821325655
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SARAH MARIE PROVIDENCE PHARMD

Provider Business Mailing Address
First Line	:	UNIVERSITY DRIVE C
Second Line	:	VA PITTSBURGH HEALTHCARE SYSTEM
City	:	PITTSBURGH
State	:	PA
Zip	:	15240
Country	:	US
Telephone Number	:	412-360-3423
Fax Number	:	412-360-6193

Provider Business Practice Location Address
First Line	:	UNIVERSITY DRIVE C
Second Line	:	132M-U
City	:	PITTSBURGH
State	:	PA
Zip	:	15240-1003
Country	:	US
Telephone Number	:	412-360-3423
Fax Number	:	412-360-6193

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

Provider Enumeration Date	:	11/16/2009
Last Update Date	:	06/30/2022

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Directions to “ SARAH MARIE PROVIDENCE PHARMD” Practice Location

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