Provider Demographics
NPI:1437698891
Name:HAGER, SHERRY BLEVINS (RPH)
Entity Type:Individual
Prefix:MRS
First Name:SHERRY
Middle Name:BLEVINS
Last Name:HAGER
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 1:722 SULLIVAN ROAD
Mailing Address - Street 2:
Mailing Address - City:STATESVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28677
Mailing Address - Country:US
Mailing Address - Phone:704-872-3984
Mailing Address - Fax:704-872-3958
Practice Address - Street 1:722 SULLIVAN ROAD
Practice Address - Street 2:
Practice Address - City:STATESVILLE
Practice Address - State:NC
Practice Address - Zip Code:28677
Practice Address - Country:US
Practice Address - Phone:704-872-3984
Practice Address - Fax:704-872-3958
Is Sole Proprietor?:No
Enumeration Date:2017-02-17
Last Update Date:2018-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC13434183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist