Provider Demographics
NPI:1508135088
Name:DECUIR, SHERRY B (RPH)
Entity Type:Individual
Prefix:MRS
First Name:SHERRY
Middle Name:B
Last Name:DECUIR
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 1:13900 SHELBYVILLE RD
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40245-3906
Mailing Address - Country:US
Mailing Address - Phone:502-244-8546
Mailing Address - Fax:
Practice Address - Street 1:13900 SHELBYVILLE RD
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40245-3906
Practice Address - Country:US
Practice Address - Phone:502-244-8546
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-12-29
Last Update Date:2012-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY010927183500000X
GA018144183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist