Provider Demographics
NPI:1215307186
Name:PETRONE, SARAH KATHERINE (PHARMD)
Entity type:Individual
Prefix:
First Name:SARAH
Middle Name:KATHERINE
Last Name:PETRONE
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 1:1309 ABBEYWOOD RD
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40222-6503
Mailing Address - Country:US
Mailing Address - Phone:502-640-0445
Mailing Address - Fax:
Practice Address - Street 1:9801 BROWNSBORO RD
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40241-1125
Practice Address - Country:US
Practice Address - Phone:502-327-7342
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-10-04
Last Update Date:2015-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY017917183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist