Provider Demographics
NPI:1679868145
Name:HENNESSEY, CHERI N (RPH)
Entity Type:Individual
Prefix:
First Name:CHERI
Middle Name:N
Last Name:HENNESSEY
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:SAM'S CLUB PHARMACY
Mailing Address - Street 2:1250 AIRPORT BLVD
Mailing Address - City:PENSACOLA
Mailing Address - State:FL
Mailing Address - Zip Code:32504
Mailing Address - Country:US
Mailing Address - Phone:850-477-7974
Mailing Address - Fax:850-477-9692
Practice Address - Street 1:1250 AIRPORT BLVD
Practice Address - Street 2:
Practice Address - City:PENSACOLA
Practice Address - State:FL
Practice Address - Zip Code:32504-8610
Practice Address - Country:US
Practice Address - Phone:850-477-7974
Practice Address - Fax:850-477-9692
Is Sole Proprietor?:No
Enumeration Date:2011-06-13
Last Update Date:2023-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL11683183500000X
FLPS0026549183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist