Provider Demographics
NPI:1225242720
Name:SHERARD, CHAD MARK (RPH)
Entity Type:Individual
Prefix:MR
First Name:CHAD
Middle Name:MARK
Last Name:SHERARD
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:46722 MEADOWLARK LN
Mailing Address - Street 2:
Mailing Address - City:SIOUX FALLS
Mailing Address - State:SD
Mailing Address - Zip Code:57107-6022
Mailing Address - Country:US
Mailing Address - Phone:605-373-0100
Mailing Address - Fax:605-373-4832
Practice Address - Street 1:4901 N 4TH AVE
Practice Address - Street 2:
Practice Address - City:SIOUX FALLS
Practice Address - State:SD
Practice Address - Zip Code:57104-0444
Practice Address - Country:US
Practice Address - Phone:605-373-0100
Practice Address - Fax:605-373-4832
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SD4858183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist