Provider Demographics
NPI:1588261390
Name:PANAHI, SARA (PHARMD)
Entity type:Individual
Prefix:DR
First Name:SARA
Middle Name:
Last Name:PANAHI
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 1:65 AMERICA ST APT 3
Mailing Address - Street 2:
Mailing Address - City:PROVIDENCE
Mailing Address - State:RI
Mailing Address - Zip Code:02903-5427
Mailing Address - Country:US
Mailing Address - Phone:303-803-8237
Mailing Address - Fax:
Practice Address - Street 1:10 DAVOL SQ STE 400
Practice Address - Street 2:
Practice Address - City:PROVIDENCE
Practice Address - State:RI
Practice Address - Zip Code:02903-4760
Practice Address - Country:US
Practice Address - Phone:303-803-8237
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-10-05
Last Update Date:2020-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIRPH061731835P2201X, 183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
No1835P2201XPharmacy Service ProvidersPharmacistAmbulatory Care