Provider Demographics
NPI:1699527036
Name:KMETZ, SARAH
Entity type:Individual
Prefix:
First Name:SARAH
Middle Name:
Last Name:KMETZ
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 1:3909 ORANGE PL STE 2250
Mailing Address - Street 2:
Mailing Address - City:BEACHWOOD
Mailing Address - State:OH
Mailing Address - Zip Code:44122-4481
Mailing Address - Country:US
Mailing Address - Phone:216-896-1712
Mailing Address - Fax:
Practice Address - Street 1:3909 ORANGE PL STE 2250
Practice Address - Street 2:
Practice Address - City:BEACHWOOD
Practice Address - State:OH
Practice Address - Zip Code:44122-4481
Practice Address - Country:US
Practice Address - Phone:216-896-1712
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-04-01
Last Update Date:2024-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH03236458183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist