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General NPI Number Information
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NPI Number | 1295011252
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Entity Type | Individual
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Provider Name | ANTARA SHERGILL-HIRSH RPH
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Gender | Female
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Dates
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Enumeration Date | 10/21/2011
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Last Update Date | 10/21/2011
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Provider Practice Location Address
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Address Line | 11290 DONNER PASS RD
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City | TRUCKEE
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State | CA
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Zip | 96161-4808
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Country | US
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Telephone | 530-582-7952
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 3776
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City | INCLINE VILLAGE
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State | NV
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Zip | 89450-3776
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Country | US
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Telephone | 775-832-2452
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 52264
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 17073
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License Number State | NV
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