MEDICARE: SHERRI JACKSON DAVIS

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	0202012301	VA

General Provider Information

NPI Number	:	1902112139
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SHERRI JACKSON DAVIS

Provider Business Mailing Address
First Line	:	6135 E VIRGINIA BEACH BLVD
Second Line	:
City	:	NORFOLK
State	:	VA
Zip	:	23502-2701
Country	:	US
Telephone Number	:	757-466-7962
Fax Number	:

Provider Business Practice Location Address
First Line	:	6135 E VIRGINIA BEACH BLVD
Second Line	:
City	:	NORFOLK
State	:	VA
Zip	:	23502-2701
Country	:	US
Telephone Number	:	757-466-7962
Fax Number	:

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

Provider Enumeration Date	:	08/25/2010
Last Update Date	:	08/25/2010

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