Provider Demographics
NPI:1043941032
Name:MOSS, SARAH ANN (PHARMD, MPH, BCACP)
Entity type:Individual
Prefix:
First Name:SARAH
Middle Name:ANN
Last Name:MOSS
Suffix:
Gender:F
Credentials:PHARMD, MPH, BCACP
Other - Prefix:
Other - First Name:SARAH
Other - Middle Name:ANN
Other - Last Name:LOTHSPEICH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PHARMD, MPH, BCACP
Mailing Address - Street 1:PO BOX 110429
Mailing Address - Street 2:
Mailing Address - City:AURORA
Mailing Address - State:CO
Mailing Address - Zip Code:80042-0429
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:12605 E 16TH AVE
Practice Address - Street 2:
Practice Address - City:AURORA
Practice Address - State:CO
Practice Address - Zip Code:80045-2545
Practice Address - Country:US
Practice Address - Phone:720-848-0000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-06-21
Last Update Date:2024-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COPHA.00239741835P2201X
CO1835P2201X183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
No1835P2201XPharmacy Service ProvidersPharmacistAmbulatory Care