Basic Information
Provider Information
NPI: 1346593399
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: HORBACH
FirstName: SARAH
MiddleName: E
NamePrefix:  
NameSuffix:  
Credential: PA-C
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName: SCHOLES
OtherFirstName: SARAH
OtherMiddleName: E
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential: PA-C
OtherLastNameType: 1
Mailing Information
Address1: 1011 REED AVE
Address2: SUITE 300
City: WYOMISSING
State: PA
PostalCode: 196102002
CountryCode: US
TelephoneNumber: 6103744401
FaxNumber: 6103747140
Practice Location
Address1: 1011 REED AVE
Address2: SUITE 300
City: WYOMISSING
State: PA
PostalCode: 196102002
CountryCode: US
TelephoneNumber: 6103744401
FaxNumber: 6103747140
Other Information
ProviderEnumerationDate: 10/16/2012
LastUpdateDate: 11/21/2016
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
363AM0700XMA055810PAY Physician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical

No ID Information.


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