Provider Demographics
NPI:1639470107
Name:CLARKE, CHERYL ANNETTE (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:CHERYL
Middle Name:ANNETTE
Last Name:CLARKE
Suffix:
Gender:F
Credentials:PHARMD
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Other - Credentials:
Mailing Address - Street 1:DILORENZO TRICARE HEALTH CLINIC
Mailing Address - Street 2:MG918B CORRIDOR 8, THE PENTAGON
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20310-0001
Mailing Address - Country:US
Mailing Address - Phone:703-692-8694
Mailing Address - Fax:703-692-0899
Practice Address - Street 1:DILORENZO TRICARE HEALTH CLINIC
Practice Address - Street 2:MG918B CORRIDOR 8, THE PENTAGON
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20310-0001
Practice Address - Country:US
Practice Address - Phone:703-692-8694
Practice Address - Fax:703-692-0899
Is Sole Proprietor?:No
Enumeration Date:2010-11-15
Last Update Date:2013-08-30
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
VA0202205388183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist