Provider Demographics
NPI:1447533617
Name:MCCOY, SARAH (PHARMD)
Entity type:Individual
Prefix:DR
First Name:SARAH
Middle Name:
Last Name:MCCOY
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:PO BOX 1326
Mailing Address - Street 2:
Mailing Address - City:RUSSELLVILLE
Mailing Address - State:AR
Mailing Address - Zip Code:72811-1326
Mailing Address - Country:US
Mailing Address - Phone:479-970-7547
Mailing Address - Fax:
Practice Address - Street 1:1100 E MAIN ST
Practice Address - Street 2:
Practice Address - City:RUSSELLVILLE
Practice Address - State:AR
Practice Address - Zip Code:72801-5319
Practice Address - Country:US
Practice Address - Phone:479-967-1573
Practice Address - Fax:479-967-1594
Is Sole Proprietor?:No
Enumeration Date:2011-09-23
Last Update Date:2011-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARPD10986183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist