Provider Demographics
NPI:1114214186
Name:SHARABY, SHERIF
Entity Type:Individual
Prefix:
First Name:SHERIF
Middle Name:
Last Name:SHARABY
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5473 N SALINAS AVE
Mailing Address - Street 2:APT 251
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93722-6056
Mailing Address - Country:US
Mailing Address - Phone:559-674-2182
Mailing Address - Fax:
Practice Address - Street 1:335 W OLIVE AVE
Practice Address - Street 2:RITE AID PHARMACY
Practice Address - City:MADERA
Practice Address - State:CA
Practice Address - Zip Code:93637-5402
Practice Address - Country:US
Practice Address - Phone:559-674-2182
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-06-29
Last Update Date:2012-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA65327183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist