Provider Demographics
NPI:1154799633
Name:FARAG, SARA (RPH)
Entity type:Individual
Prefix:
First Name:SARA
Middle Name:
Last Name:FARAG
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3809 E WATKINS ST
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85034-7264
Mailing Address - Country:US
Mailing Address - Phone:855-745-5725
Mailing Address - Fax:
Practice Address - Street 1:3809 E WATKINS ST
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85034-7264
Practice Address - Country:US
Practice Address - Phone:855-745-5725
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-09-14
Last Update Date:2022-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZS021243183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist