Provider Demographics
NPI:1396469250
Name:CASH, SARA LUE
Entity type:Individual
Prefix:
First Name:SARA
Middle Name:LUE
Last Name:CASH
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1209 OAKLAND RD
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23231-4664
Mailing Address - Country:US
Mailing Address - Phone:804-901-1683
Mailing Address - Fax:
Practice Address - Street 1:1209 OAKLAND RD
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23231-4664
Practice Address - Country:US
Practice Address - Phone:804-901-1683
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-10-03
Last Update Date:2022-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
T67128364172A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172A00000XOther Service ProvidersDriver