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General NPI Number Information
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NPI Number | 1407876311
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Entity Type | Organization
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Legal Business Name | SHERMAN PHARMACY
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Dates
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Enumeration Date | 07/20/2006
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Last Update Date | 09/10/2014
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Provider Practice Location Address
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Address Line | 105 WEST MAIN STREET
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City | SHERMAN
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State | NY
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Zip | 14781
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Country | US
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Telephone | 716-761-6876
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Fax | 716-761-6224
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Provider Business Mailing Address
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Address Line | 105 WEST MAIN STREET
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City | SHERMAN
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State | NY
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Zip | 14781
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Country | US
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Telephone | 716-761-6876
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Fax | 716-761-6224
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Authorized Official
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Title or Position | OWNER
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Name | MR. SHAKUR I SARVAIYA
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Credential | RPH
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Telephone | 716-761-6876
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number | 018267
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License Number State | NY
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