Provider Demographics
NPI:1871861369
Name:ACKERMANN, CHERRY CROCKER (PHARMD)
Entity Type:Individual
Prefix:MRS
First Name:CHERRY
Middle Name:CROCKER
Last Name:ACKERMANN
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:268 WINCHESTER CT
Mailing Address - Street 2:
Mailing Address - City:WEST COLUMBIA
Mailing Address - State:SC
Mailing Address - Zip Code:29170-1061
Mailing Address - Country:US
Mailing Address - Phone:803-551-1030
Mailing Address - Fax:803-551-0003
Practice Address - Street 1:3250 HARDEN STREET EXT
Practice Address - Street 2:SUITE 300
Practice Address - City:COLUMBIA
Practice Address - State:SC
Practice Address - Zip Code:29203-6842
Practice Address - Country:US
Practice Address - Phone:803-551-1030
Practice Address - Fax:803-551-0003
Is Sole Proprietor?:No
Enumeration Date:2011-12-12
Last Update Date:2011-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC8136183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist