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General NPI Number Information
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NPI Number | 1598906661
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Entity Type | Individual
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Provider Name | SHERYL CHAN RPH
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Gender | Female
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Dates
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Enumeration Date | 03/18/2009
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Last Update Date | 02/20/2017
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Provider Practice Location Address
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Address Line | 6310 SOUTHWEST BLVD
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City | FORT WORTH
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State | TX
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Zip | 76109-3998
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Country | US
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Telephone | 800-556-4246
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Fax | 817-263-0844
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Provider Business Mailing Address
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Address Line | 36 W 37TH ST FL 5
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City | NEW YORK
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State | NY
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Zip | 10018-7497
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Country | US
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Telephone | 800-746-9089
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Fax | 212-398-4812
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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 | 042817
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License Number State | NY
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