Healthcare Provider Details

I. General information

NPI: 1891366530
Provider Name (Legal Business Name): CHERYL DAWN SYKES PHARMACY TECHNICIAN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/04/2021
Last Update Date: 07/04/2021
Certification Date: 07/04/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

300 W CARLETON RD
HILLSDALE MI
49242-1048
US

IV. Provider business mailing address

300 W CARLETON RD
HILLSDALE MI
49242-1048
US

V. Phone/Fax

Practice location:
  • Phone: 517-437-3373
  • Fax:
Mailing address:
  • Phone: 517-437-3373
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183700000X
TaxonomyPharmacy Technician
License Number5303018690
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: