Provider Demographics
NPI:1376882068
Name:MANKARYOUS, SHERIF S (RPH)
Entity Type:Individual
Prefix:
First Name:SHERIF
Middle Name:S
Last Name:MANKARYOUS
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 1:879 E EXCHANGE ST
Mailing Address - Street 2:
Mailing Address - City:AKRON
Mailing Address - State:OH
Mailing Address - Zip Code:44306
Mailing Address - Country:US
Mailing Address - Phone:330-375-5040
Mailing Address - Fax:330-375-5048
Practice Address - Street 1:879 E EXCHANGE ST
Practice Address - Street 2:
Practice Address - City:AKRON
Practice Address - State:OH
Practice Address - Zip Code:44306-1127
Practice Address - Country:US
Practice Address - Phone:440-725-9938
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-01-31
Last Update Date:2020-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH031299951183500000X, 1835P0018X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P0018XPharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
No183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH031299951OtherOHIO STATE BOARD OF PHARMACY
OHH185110OtherMASS IMMUNIZATION ROSTER BILLER