Provider Demographics
NPI:1528497757
Name:WRIGHT, SANDRA S (PHARMD)
Entity type:Individual
Prefix:DR
First Name:SANDRA
Middle Name:S
Last Name:WRIGHT
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 1:4310 67TH DR
Mailing Address - Street 2:
Mailing Address - City:UNION GROVE
Mailing Address - State:WI
Mailing Address - Zip Code:53182-9338
Mailing Address - Country:US
Mailing Address - Phone:262-878-1171
Mailing Address - Fax:
Practice Address - Street 1:4310 67TH DR
Practice Address - Street 2:
Practice Address - City:UNION GROVE
Practice Address - State:WI
Practice Address - Zip Code:53182-9338
Practice Address - Country:US
Practice Address - Phone:262-878-1171
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-11-07
Last Update Date:2014-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI16156-40183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist