Provider Demographics
NPI:1518292713
Name:MCCORMICK, SHERI LYN (RPH)
Entity Type:Individual
Prefix:
First Name:SHERI
Middle Name:LYN
Last Name:MCCORMICK
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 1:13619 N 71ST DR
Mailing Address - Street 2:
Mailing Address - City:PEORIA
Mailing Address - State:AZ
Mailing Address - Zip Code:85381-5092
Mailing Address - Country:US
Mailing Address - Phone:623-486-7783
Mailing Address - Fax:623-486-0346
Practice Address - Street 1:5116 W OLIVE AVE
Practice Address - Street 2:
Practice Address - City:GLENDALE
Practice Address - State:AZ
Practice Address - Zip Code:85302-4209
Practice Address - Country:US
Practice Address - Phone:623-937-4771
Practice Address - Fax:623-915-9519
Is Sole Proprietor?:No
Enumeration Date:2009-10-06
Last Update Date:2009-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZS0090891835P0018X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P0018XPharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist