Provider Demographics
NPI:1851423826
Name:SHERRILL, CRAIG L (RPH)
Entity Type:Individual
Prefix:MR
First Name:CRAIG
Middle Name:L
Last Name:SHERRILL
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:CRAIG
Other - Middle Name:L
Other - Last Name:BATES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RPH
Mailing Address - Street 1:104 SENNA ST
Mailing Address - Street 2:
Mailing Address - City:MARIETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30064-4415
Mailing Address - Country:US
Mailing Address - Phone:404-622-3040
Mailing Address - Fax:
Practice Address - Street 1:104 SENNA ST
Practice Address - Street 2:
Practice Address - City:MARIETTA
Practice Address - State:GA
Practice Address - Zip Code:30064-4415
Practice Address - Country:US
Practice Address - Phone:404-622-3040
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-12
Last Update Date:2021-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX42031183500000X
LA15293183500000X
GARPH019400183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist