Provider Demographics
NPI:1073899639
Name:BOURGOIN, SARAH (PHARM D)
Entity type:Individual
Prefix:DR
First Name:SARAH
Middle Name:
Last Name:BOURGOIN
Suffix:
Gender:
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 1:41 BREWSTER RD
Mailing Address - Street 2:
Mailing Address - City:BRISTOL
Mailing Address - State:CT
Mailing Address - Zip Code:06010-5141
Mailing Address - Country:US
Mailing Address - Phone:860-845-5232
Mailing Address - Fax:860-585-3846
Practice Address - Street 1:41 BREWSTER RD
Practice Address - Street 2:
Practice Address - City:BRISTOL
Practice Address - State:CT
Practice Address - Zip Code:06010-5161
Practice Address - Country:US
Practice Address - Phone:608-455-2328
Practice Address - Fax:860-585-3846
Is Sole Proprietor?:No
Enumeration Date:2011-10-27
Last Update Date:2025-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CTPCT.0011600183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist