Provider Demographics
NPI:1245337971
Name:CAMILLI, SARA LUND (PHARMD)
Entity type:Individual
Prefix:DR
First Name:SARA
Middle Name:LUND
Last Name:CAMILLI
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:DR
Other - First Name:SARA
Other - Middle Name:ELIZABETH
Other - Last Name:LUND
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PHARMD
Mailing Address - Street 1:8535 2ND AVE
Mailing Address - Street 2:
Mailing Address - City:SILVER SPRING
Mailing Address - State:MD
Mailing Address - Zip Code:20910-3378
Mailing Address - Country:US
Mailing Address - Phone:202-368-4531
Mailing Address - Fax:
Practice Address - Street 1:10903 NEW HAMPSHIRE AVE
Practice Address - Street 2:WO22 MS 3411
Practice Address - City:SILVER SPRING
Practice Address - State:MD
Practice Address - Zip Code:20993
Practice Address - Country:US
Practice Address - Phone:301-796-4203
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-09-17
Last Update Date:2010-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL051.291326183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist