Provider Demographics
NPI:1750888137
Name:SANDERS, STEVE JASON (PHARMD)
Entity type:Individual
Prefix:
First Name:STEVE
Middle Name:JASON
Last Name:SANDERS
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:370 MCARTHUR CIR
Mailing Address - Street 2:
Mailing Address - City:MOUNT VERNON
Mailing Address - State:GA
Mailing Address - Zip Code:30445-3429
Mailing Address - Country:US
Mailing Address - Phone:912-585-2233
Mailing Address - Fax:912-529-4344
Practice Address - Street 1:370 MCARTHUR CIR
Practice Address - Street 2:
Practice Address - City:MOUNT VERNON
Practice Address - State:GA
Practice Address - Zip Code:30445-3429
Practice Address - Country:US
Practice Address - Phone:912-585-2233
Practice Address - Fax:912-529-4344
Is Sole Proprietor?:Yes
Enumeration Date:2018-04-11
Last Update Date:2018-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARPH0268931835P0018X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P0018XPharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist