Healthcare Provider Details

I. General information

NPI: 1932478625
Provider Name (Legal Business Name): SHERONE RUGGS PHARM.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/24/2011
Last Update Date: 12/24/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3145 PLAYERS CLUB PKWY
MEMPHIS TN
38125-8835
US

IV. Provider business mailing address

5947 BAIRD DR
MEMPHIS TN
38119-7302
US

V. Phone/Fax

Practice location:
  • Phone: 901-748-2620
  • Fax:
Mailing address:
  • Phone: 901-537-1377
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number24540
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: