Provider Demographics
NPI:1013593367
Name:WITTERS, SHERRY E (RPH)
Entity Type:Individual
Prefix:MRS
First Name:SHERRY
Middle Name:E
Last Name:WITTERS
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1066 GREEN MEADOW RD
Mailing Address - Street 2:
Mailing Address - City:CHARLESTON
Mailing Address - State:WV
Mailing Address - Zip Code:25314-2046
Mailing Address - Country:US
Mailing Address - Phone:304-542-8733
Mailing Address - Fax:
Practice Address - Street 1:1601 KANAWHA BLVD W STE 200
Practice Address - Street 2:
Practice Address - City:CHARLESTON
Practice Address - State:WV
Practice Address - Zip Code:25387-2539
Practice Address - Country:US
Practice Address - Phone:304-345-4836
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-03-18
Last Update Date:2021-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WVRP0005145183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist