Provider Demographics
NPI:1316397235
Name:HARRIS, SARA ELIZABETH (RPH)
Entity type:Individual
Prefix:MS
First Name:SARA
Middle Name:ELIZABETH
Last Name:HARRIS
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 1:1664 ROSELAWN AVE
Mailing Address - Street 2:
Mailing Address - City:NEW ALBANY
Mailing Address - State:IN
Mailing Address - Zip Code:47150-1836
Mailing Address - Country:US
Mailing Address - Phone:812-946-2421
Mailing Address - Fax:
Practice Address - Street 1:1220 MISSOURI AVE
Practice Address - Street 2:
Practice Address - City:JEFFERSONVILLE
Practice Address - State:IN
Practice Address - Zip Code:47130-3725
Practice Address - Country:US
Practice Address - Phone:812-283-2272
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-06-22
Last Update Date:2016-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN26020947A183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist