Provider Demographics
NPI:1982426821
Name:ROE, SARAH RUTH ANN (PHARMD)
Entity type:Individual
Prefix:
First Name:SARAH
Middle Name:RUTH ANN
Last Name:ROE
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:SARAH
Other - Middle Name:RUTH ANN
Other - Last Name:MADDEN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PHARMD
Mailing Address - Street 1:910799 S MOCCASIN TRL
Mailing Address - Street 2:
Mailing Address - City:CHANDLER
Mailing Address - State:OK
Mailing Address - Zip Code:74834-6051
Mailing Address - Country:US
Mailing Address - Phone:405-240-7200
Mailing Address - Fax:
Practice Address - Street 1:356110 E 930 RD
Practice Address - Street 2:
Practice Address - City:STROUD
Practice Address - State:OK
Practice Address - Zip Code:74079-5184
Practice Address - Country:US
Practice Address - Phone:918-968-9531
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-10-31
Last Update Date:2024-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK19614183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist