Provider Demographics
NPI:1003138371
Name:PERRY, SHARON ANN
Entity Type:Individual
Prefix:MRS
First Name:SHARON
Middle Name:ANN
Last Name:PERRY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1072 MOUNTAIN LAUREL PLZ
Mailing Address - Street 2:
Mailing Address - City:LATROBE
Mailing Address - State:PA
Mailing Address - Zip Code:15650-5214
Mailing Address - Country:US
Mailing Address - Phone:724-537-9412
Mailing Address - Fax:724-537-9522
Practice Address - Street 1:1072 MOUNTAIN LAUREL PLZ
Practice Address - Street 2:
Practice Address - City:LATROBE
Practice Address - State:PA
Practice Address - Zip Code:15650-5214
Practice Address - Country:US
Practice Address - Phone:724-537-9412
Practice Address - Fax:724-537-9522
Is Sole Proprietor?:Yes
Enumeration Date:2010-02-26
Last Update Date:2010-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARP039107L183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist