Provider Demographics
NPI:1558960914
Name:CHERRY, SCOTT (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:SCOTT
Middle Name:
Last Name:CHERRY
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:855 WILMONT LN
Mailing Address - Street 2:
Mailing Address - City:NEWPORT NEWS
Mailing Address - State:VA
Mailing Address - Zip Code:23608-3233
Mailing Address - Country:US
Mailing Address - Phone:175-787-9303
Mailing Address - Fax:
Practice Address - Street 1:1470 QUARTERPATH RD
Practice Address - Street 2:
Practice Address - City:WILLIAMSBURG
Practice Address - State:VA
Practice Address - Zip Code:23185-6500
Practice Address - Country:US
Practice Address - Phone:757-253-0385
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-10-18
Last Update Date:2020-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VAVA0202207124183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist