Provider Demographics
NPI:1164737144
Name:BRANUM, CHERYL (RPH)
Entity Type:Individual
Prefix:
First Name:CHERYL
Middle Name:
Last Name:BRANUM
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 1:15950 S RANCHO SAHUARITA BLVD
Mailing Address - Street 2:
Mailing Address - City:SAHUARITA
Mailing Address - State:AZ
Mailing Address - Zip Code:85629-8010
Mailing Address - Country:US
Mailing Address - Phone:520-648-7701
Mailing Address - Fax:520-648-7703
Practice Address - Street 1:15950 S RANCHO SAHUARITA BLVD
Practice Address - Street 2:
Practice Address - City:SAHUARITA
Practice Address - State:AZ
Practice Address - Zip Code:85629-8010
Practice Address - Country:US
Practice Address - Phone:520-648-7701
Practice Address - Fax:520-648-7703
Is Sole Proprietor?:No
Enumeration Date:2010-08-13
Last Update Date:2010-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ15927183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist