Provider Demographics
NPI:1801496252
Name:POLLEY, SARAH ELIZABETH (PHARMD)
Entity type:Individual
Prefix:
First Name:SARAH
Middle Name:ELIZABETH
Last Name:POLLEY
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:SARAH
Other - Middle Name:ELIZABETH
Other - Last Name:KELSAY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:8191 UPLAND WAY
Mailing Address - Street 2:
Mailing Address - City:CAMBY
Mailing Address - State:IN
Mailing Address - Zip Code:46113-7800
Mailing Address - Country:US
Mailing Address - Phone:317-856-9521
Mailing Address - Fax:
Practice Address - Street 1:8191 UPLAND WAY
Practice Address - Street 2:
Practice Address - City:CAMBY
Practice Address - State:IN
Practice Address - Zip Code:46113-7800
Practice Address - Country:US
Practice Address - Phone:317-856-9521
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-10-27
Last Update Date:2020-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN26026029A183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist