Provider Demographics
NPI:1285395822
Name:STOCKMASTER, SARAH J
Entity type:Individual
Prefix:
First Name:SARAH
Middle Name:J
Last Name:STOCKMASTER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:SARAH
Other - Middle Name:J
Other - Last Name:ROGERS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:7060 TOWNSHIP ROAD 204
Mailing Address - Street 2:
Mailing Address - City:BELLEVUE
Mailing Address - State:OH
Mailing Address - Zip Code:44811-8835
Mailing Address - Country:US
Mailing Address - Phone:419-951-3243
Mailing Address - Fax:
Practice Address - Street 1:359 N LEXINGTON SPRINGMILL RD
Practice Address - Street 2:
Practice Address - City:ONTARIO
Practice Address - State:OH
Practice Address - Zip Code:44906-3808
Practice Address - Country:US
Practice Address - Phone:419-529-2487
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-01-05
Last Update Date:2022-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH03440048183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist