Healthcare Provider Details
I. General information
NPI: 1811582778
Provider Name (Legal Business Name): SHERIKA LASHEA WHEELER PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 03/03/2021
Last Update Date: 03/03/2021
Certification Date: 03/03/2021
Deactivation Date:
Reactivation Date:
III. Provider practice location address
2600 MCINGVALE RD
HERNANDO MS
38632-8658
US
IV. Provider business mailing address
7913 SYCAMORE DR
SOUTHAVEN MS
38671-8423
US
V. Phone/Fax
- Phone: 662-429-8767
- Fax:
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 183500000X |
| Taxonomy | Pharmacist |
| License Number | 43728 |
| License Number State | TN |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 183500000X |
| Taxonomy | Pharmacist |
| License Number | E-15091 |
| License Number State | MS |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: