Healthcare Provider Details

I. General information

NPI: 1821694902
Provider Name (Legal Business Name): EMILY JANE SHERMAN PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/05/2020
Last Update Date: 12/05/2020
Certification Date: 12/01/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

505 E 1100 N
CHESTERTON IN
46304-9697
US

IV. Provider business mailing address

505 E 1100 N
CHESTERTON IN
46304-9697
US

V. Phone/Fax

Practice location:
  • Phone: 219-926-1420
  • Fax:
Mailing address:
  • Phone: 219-926-1420
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number26028628A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: