Basic Information
Provider Information
NPI: 1548530462
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: MOORE-PRZYBOROWSKI
FirstName: SARAH
MiddleName:  
NamePrefix: DR.
NameSuffix:  
Credential: PHARM.D.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 2001 PINER RD APT 186
Address2:  
City: SANTA ROSA
State: CA
PostalCode: 954036964
CountryCode: US
TelephoneNumber: 7029853119
FaxNumber:  
Practice Location
Address1: 7800 OLD REDWOOD HWY
Address2:  
City: COTATI
State: CA
PostalCode: 949315106
CountryCode: US
TelephoneNumber: 7077956014
FaxNumber:  
Other Information
ProviderEnumerationDate: 01/10/2012
LastUpdateDate: 01/10/2012
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: Y
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
183500000X66797CAY Pharmacy Service ProvidersPharmacist 
183500000X18085NVN Pharmacy Service ProvidersPharmacist 

No ID Information.


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