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Individual

SARA L. DEAN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
RPH

Contact information

Practice address
12450 LA GRANGE RD, LOUISVILLE, KY 40245-1901
(502) 241-6770
(502) 241-5909
Mailing address
12450 LA GRANGE RD, LOUISVILLE, KY 40245-1901
(502) 241-6770
(502) 241-5909

Taxonomy

Speciality
Code
Description
License number
State
183500000X
Pharmacist
0000003763
TN
183500000X
Pharmacist
Primary
006821
KY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0000003763
TENNESSE STATE PHARMACY LICENCE NUMBER
TN
01
006821
KENTUCKY BOARD OF PHARMACY PHARMACIST ID
KY
Enumeration date
06/13/2011
Last updated
06/13/2011
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