Provider Demographics
NPI:1881637981
Name:MCDONALD, SHERRIE ANN (RPH)
Entity Type:Individual
Prefix:
First Name:SHERRIE
Middle Name:ANN
Last Name:MCDONALD
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 1:5224 FIELDSTONE DRIVE
Mailing Address - Street 2:
Mailing Address - City:CONCORD
Mailing Address - State:NC
Mailing Address - Zip Code:28020
Mailing Address - Country:US
Mailing Address - Phone:704-795-4599
Mailing Address - Fax:
Practice Address - Street 1:5006 HIGHWAY 49 S
Practice Address - Street 2:
Practice Address - City:HARRISBURG
Practice Address - State:NC
Practice Address - Zip Code:28075-8465
Practice Address - Country:US
Practice Address - Phone:704-454-7948
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-06-14
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC13530183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC0135935Medicaid
NC5534940001Medicare ID - Type UnspecifiedMEDICARE PROVIDER NUMBER