Provider Demographics
NPI:1568248326
Name:SHERROD, KASSANDRA (RPH)
Entity Type:Individual
Prefix:MRS
First Name:KASSANDRA
Middle Name:
Last Name:SHERROD
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 1:8301 PROFESSIONAL PL STE 115
Mailing Address - Street 2:
Mailing Address - City:HYATTSVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20785-2351
Mailing Address - Country:US
Mailing Address - Phone:301-341-8811
Mailing Address - Fax:
Practice Address - Street 1:8301 PROFESSIONAL PL STE 115
Practice Address - Street 2:
Practice Address - City:HYATTSVILLE
Practice Address - State:MD
Practice Address - Zip Code:20785-2351
Practice Address - Country:US
Practice Address - Phone:301-341-8811
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-09-06
Last Update Date:2023-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD13247183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist