MEDICARE: MRS. SHERI LYNETTE MARSHALL R.PH.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	183500000X	Pharmacist	044211	MO

General Provider Information

NPI Number	:	1013904630
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. SHERI LYNETTE MARSHALL R.PH.

Provider Business Mailing Address
First Line	:	3829 FREDERICK AVE
Second Line	:
City	:	SAINT JOSEPH
State	:	MO
Zip	:	64506-3020
Country	:	US
Telephone Number	:	816-279-1668
Fax Number	:	816-279-6425

Provider Business Practice Location Address
First Line	:	3829 FREDERICK AVE
Second Line	:
City	:	SAINT JOSEPH
State	:	MO
Zip	:	64506-3020
Country	:	US
Telephone Number	:	816-279-1668
Fax Number	:	816-279-6425

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/29/2005
Last Update Date	:	07/08/2007

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