Provider Demographics
NPI:1275632721
Name:SHERROW, GINA LOU (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:GINA
Middle Name:LOU
Last Name:SHERROW
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:514 WILLAILLA ROAD
Mailing Address - Street 2:
Mailing Address - City:BRODHEAD
Mailing Address - State:KY
Mailing Address - Zip Code:40409
Mailing Address - Country:US
Mailing Address - Phone:606-758-8989
Mailing Address - Fax:
Practice Address - Street 1:1088 HWY 490
Practice Address - Street 2:
Practice Address - City:EAST BERNSTADT
Practice Address - State:KY
Practice Address - Zip Code:40729
Practice Address - Country:US
Practice Address - Phone:606-843-2211
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY012048183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist