Provider Demographics
NPI:1417363284
Name:MASON, SHERRY L (RPH)
Entity Type:Individual
Prefix:
First Name:SHERRY
Middle Name:L
Last Name:MASON
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 1:10052 LEGOLAS LN
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28269-6985
Mailing Address - Country:US
Mailing Address - Phone:828-226-4691
Mailing Address - Fax:828-165-1244
Practice Address - Street 1:10052 LEGOLAS LN
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28269-6985
Practice Address - Country:US
Practice Address - Phone:828-226-4691
Practice Address - Fax:828-165-1244
Is Sole Proprietor?:Yes
Enumeration Date:2014-07-01
Last Update Date:2016-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC14561183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist