Sarah Shore Anderson, PHARMD
Individual provider Active NPI Pharmacist · White Bear Lake, MN
NPI 1558086868 · NPPES record last updated Oct 10, 2022
Key facts
- NPI
- 1558086868
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pharmacist 183500000X
- License
- 121434 (MN)
- Practice address
- 2269 5TH St
White Bear Lake, MN 55110-3020 - Phone
- (507) 273-1274
- NPI assigned
- Oct 10, 2022
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- Credentials
- Doctor of Pharmacy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 121434 | MN | MD | Pharmacist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist |
183500000X | 121434 | MN | Yes |
Addresses
Primary practice location
2269 5TH St
White Bear Lake, MN 55110-3020
Mailing address
2269 5TH St
White Bear Lake, MN 55110-3020
Phone (507) 273-1274
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 121434 | Other | MN | PHARMACIST LICENSE NUMBER |
Electronic endpoints
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Other URL | azova.com | Direct |
Other providers in White Bear Lake, MN
- Amanda Vaske LLC
- Aurora Elizabeth Ames
- Amiot Spine Care, PLLC
- Kristina Lorraine Anderson
- Paul Daniel Anderson
- James S Anthony
- Joel Thomas Anthony
- Arcadia Counseling LLC
- Axis Minnesota, Inc.
- Elizabeth Azamar
All providers in White Bear Lake, MN · Pharmacist in Minnesota
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 10, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.