Basic Information
| Provider Information | |||||||||
| NPI: | 1992289128 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | LINGOW | ||||||||
| FirstName: | SARA | ||||||||
| MiddleName: | ELIZABETH | ||||||||
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| Credential: | PHARMD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 4865 HAHNS PEAK DR APT 104 | ||||||||
| Address2: | |||||||||
| City: | LOVELAND | ||||||||
| State: | CO | ||||||||
| PostalCode: | 805386018 | ||||||||
| CountryCode: | US | ||||||||
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| Practice Location | |||||||||
| Address1: | 1600 23RD AVE | ||||||||
| Address2: | |||||||||
| City: | GREELEY | ||||||||
| State: | CO | ||||||||
| PostalCode: | 806346070 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9703562424 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 09/24/2018 | ||||||||
| LastUpdateDate: | 09/24/2018 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 1835P0018X | PHA.0022445 | CO | Y | Pharmacy Service Providers | Pharmacist | Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist | 1835P0018X | 201603707 | MO | N | Pharmacy Service Providers | Pharmacist | Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist | 1835P2201X | 2016023707 | MO | N | 1835P1200X | PHA.0022445 | CO | N | Pharmacy Service Providers | Pharmacist | Pharmacotherapy | 1835P1200X | 2016023707 | MO | N | Pharmacy Service Providers | Pharmacist | Pharmacotherapy | 1835P2201X | PHA.022445 | CO | N |
No ID Information.