Provider Demographics
NPI:1104113000
Name:JONES, SARA A (DPH)
Entity type:Individual
Prefix:
First Name:SARA
Middle Name:A
Last Name:JONES
Suffix:
Gender:F
Credentials:DPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2050 GALLATIN PIKE N
Mailing Address - Street 2:T0144
Mailing Address - City:MADISON
Mailing Address - State:TN
Mailing Address - Zip Code:37115-2002
Mailing Address - Country:US
Mailing Address - Phone:615-851-2928
Mailing Address - Fax:615-851-2928
Practice Address - Street 1:2050 GALLATIN PIKE N
Practice Address - Street 2:T0144
Practice Address - City:MADISON
Practice Address - State:TN
Practice Address - Zip Code:37115-2002
Practice Address - Country:US
Practice Address - Phone:615-851-2928
Practice Address - Fax:615-851-2928
Is Sole Proprietor?:Yes
Enumeration Date:2011-06-30
Last Update Date:2011-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN22275183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist