Healthcare Provider Details

I. General information

NPI: 1780614479
Provider Name (Legal Business Name): SHERN DRUG INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/05/2006
Last Update Date: 06/28/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

300 E MAIN ST
LEHI UT
84043-2242
US

IV. Provider business mailing address

300 E MAIN ST
LEHI UT
84043-2242
US

V. Phone/Fax

Practice location:
  • Phone: 801-768-4244
  • Fax: 801-768-9269
Mailing address:
  • Phone: 801-768-4244
  • Fax: 801-768-9269

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code183500000X
TaxonomyPharmacist
License Number6492942-1703
License Number StateUT
# 3
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number6492942-1703
License Number StateUT

VIII. Authorized Official

Name: CECIL DAVID SHERN
Title or Position: PHARMACY OWNER
Credential:
Phone: 801-768-4244