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General NPI Number Information
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NPI Number | 1912095506
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Entity Type | Individual
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Provider Name | SHARON D MACK RPH
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Gender | Female
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Dates
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Enumeration Date | 10/10/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 10701 EAST 9TH
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City | CLEVELAND
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State | OH
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Zip | 44106
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Country | US
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Telephone | 216-791-3800
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Fax | 216-791-3800
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Provider Business Mailing Address
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Address Line | 24832 ROCKLEDGE LN
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City | RICHMOND HEIGHTS
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State | OH
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Zip | 44143-1741
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Country | US
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Telephone | 216-255-6856
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Fax | 216-472-1405
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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 | 029567
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License Number State | TX
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