Sarah Koldeway, PHARMD
Individual provider Active NPI Pharmacist · Union Grove, WI
NPI 1699314658 · NPPES record last updated Dec 22, 2019
Key facts
- NPI
- 1699314658
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pharmacist 183500000X
- License
- 17816-40 (WI)
- Practice address
- 4310 67TH Dr
Union Grove, WI 53182-9338 - Phone
- (262) 878-1171
- NPI assigned
- Dec 22, 2019
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 2
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 |
|---|---|---|---|
| 17816-40 | WI | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Aurora Pharmacy, Inc | Past |
Accepting new patients | |
| Aurora Pharmacy, Inc. | Past |
Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 17816-40 | WI | Yes |
Addresses
Primary practice location
4310 67TH Dr
Union Grove, WI 53182-9338
Mailing address
4310 67TH Dr
Union Grove, WI 53182-9338
Phone (262) 878-1171
Other providers in Union Grove, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 22, 2019. 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.