Provider Demographics
NPI:1124782651
Name:LIRA, SARAH T (PHARMD)
Entity type:Individual
Prefix:
First Name:SARAH
Middle Name:T
Last Name:LIRA
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5537 S BETHEL LN
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:MO
Mailing Address - Zip Code:65203-9103
Mailing Address - Country:US
Mailing Address - Phone:719-289-2432
Mailing Address - Fax:
Practice Address - Street 1:115 BUSINESS LOOP 70W
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:MO
Practice Address - Zip Code:65211-6308
Practice Address - Country:US
Practice Address - Phone:573-882-7560
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-10-31
Last Update Date:2024-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO202435144183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist