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NPI Code Detail

MEDICARE: MRS. SHERRY LYNNE DEANDA RPH

MEDICARE: MRS. SHERRY LYNNE DEANDA RPH
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
1183500000XPharmacist35466TX

General Provider Information

NPI Number : 1205149911
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. SHERRY LYNNE DEANDA RPH
Provider Business Mailing Address
First Line : 3301 SHERWOOD WAY
Second Line :
City : SAN ANGELO
State : TX
Zip : 76901-3528
Country : US
Telephone Number : 325-942-0454
Fax Number : 325-949-9210
Provider Business Practice Location Address
First Line : 3301 SHERWOOD WAY
Second Line :
City : SAN ANGELO
State : TX
Zip : 76901-3528
Country : US
Telephone Number : 325-942-0454
Fax Number : 325-949-9210
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/22/2010
Last Update Date : 07/22/2010

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