Provider Demographics
NPI:1154555936
Name:BRATT, SARAH JANE (RPH)
Entity type:Individual
Prefix:
First Name:SARAH
Middle Name:JANE
Last Name:BRATT
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:SARAH
Other - Middle Name:JANE
Other - Last Name:PAKULSKI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RPH
Mailing Address - Street 1:3362 NAVARRE AVE
Mailing Address - Street 2:
Mailing Address - City:OREGON
Mailing Address - State:OH
Mailing Address - Zip Code:43616-3314
Mailing Address - Country:US
Mailing Address - Phone:419-690-8269
Mailing Address - Fax:419-690-8284
Practice Address - Street 1:3362 NAVARRE AVE
Practice Address - Street 2:
Practice Address - City:OREGON
Practice Address - State:OH
Practice Address - Zip Code:43616-3314
Practice Address - Country:US
Practice Address - Phone:419-690-8269
Practice Address - Fax:419-690-8284
Is Sole Proprietor?:No
Enumeration Date:2009-05-08
Last Update Date:2009-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH03321835183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist