Provider Demographics
NPI:1730473083
Name:ZALLAR, SHERI LYNN
Entity Type:Individual
Prefix:
First Name:SHERI
Middle Name:LYNN
Last Name:ZALLAR
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12020 BELMONT WALK WAY
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28277-3126
Mailing Address - Country:US
Mailing Address - Phone:704-540-1860
Mailing Address - Fax:
Practice Address - Street 1:9870 REA RD
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28277-6655
Practice Address - Country:US
Practice Address - Phone:704-264-3522
Practice Address - Fax:704-264-3522
Is Sole Proprietor?:Yes
Enumeration Date:2011-06-03
Last Update Date:2011-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC16664183500000X
MD14680183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist