Provider Demographics
NPI:1386528859
Name:TIBBETTS, SAVANNAH MICHELLE (PHARMD)
Entity type:Individual
Prefix:
First Name:SAVANNAH
Middle Name:MICHELLE
Last Name:TIBBETTS
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11 NORTHWOOD RD
Mailing Address - Street 2:
Mailing Address - City:MONROE
Mailing Address - State:CT
Mailing Address - Zip Code:06468-2227
Mailing Address - Country:US
Mailing Address - Phone:203-623-5578
Mailing Address - Fax:
Practice Address - Street 1:965 WHITE PLAINS RD
Practice Address - Street 2:
Practice Address - City:TRUMBULL
Practice Address - State:CT
Practice Address - Zip Code:06611-4502
Practice Address - Country:US
Practice Address - Phone:203-261-2541
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-08-05
Last Update Date:2025-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CTPCT.0017046183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist