MEDICARE: DR. SARAH L PEAKE 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	183500000X	Pharmacist	RPH029743	GA

General Provider Information

NPI Number	:	1881175883
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. SARAH L PEAKE PHARMD

Provider Business Mailing Address
First Line	:	609 VIRGINIA AVE NE APT 5209
Second Line	:
City	:	ATLANTA
State	:	GA
Zip	:	30306-3788
Country	:	US
Telephone Number	:	678-825-7194
Fax Number	:

Provider Business Practice Location Address
First Line	:	609 VIRGINIA AVE NE APT 5209
Second Line	:
City	:	ATLANTA
State	:	GA
Zip	:	30306-3788
Country	:	US
Telephone Number	:	678-825-7194
Fax Number	:

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

Provider Enumeration Date	:	08/27/2018
Last Update Date	:	08/27/2018

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