Provider Demographics
NPI:1538829007
Name:BURKS, SARA SUSANNE (PHARMD)
Entity type:Individual
Prefix:
First Name:SARA
Middle Name:SUSANNE
Last Name:BURKS
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:SARA
Other - Middle Name:SUSANNE
Other - Last Name:SPRADLING
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1235 COUNTRY CLUB CIR
Mailing Address - Street 2:
Mailing Address - City:HOOVER
Mailing Address - State:AL
Mailing Address - Zip Code:35244-1407
Mailing Address - Country:US
Mailing Address - Phone:205-441-0575
Mailing Address - Fax:
Practice Address - Street 1:1235 COUNTRY CLUB CIR
Practice Address - Street 2:
Practice Address - City:HOOVER
Practice Address - State:AL
Practice Address - Zip Code:35244-1407
Practice Address - Country:US
Practice Address - Phone:205-441-0575
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-12-27
Last Update Date:2021-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL21919183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes183500000XPharmacy Service ProvidersPharmacistGroup - Single Specialty