Provider Demographics
NPI:1437657467
Name:BURKE, SARAH (PHARM D)
Entity type:Individual
Prefix:
First Name:SARAH
Middle Name:
Last Name:BURKE
Suffix:
Gender:F
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1375 CHAMBERS RD
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43212-1560
Mailing Address - Country:US
Mailing Address - Phone:614-488-4062
Mailing Address - Fax:
Practice Address - Street 1:1375 CHAMBERS RD
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43212-1560
Practice Address - Country:US
Practice Address - Phone:614-488-4062
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-01-24
Last Update Date:2018-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH03125923183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH03125923OtherOHIO STATE BOARD OF PHARMACY LICENSE