Provider Demographics
NPI:1922280270
Name:HURLBURT, CHERI (RPH)
Entity Type:Individual
Prefix:
First Name:CHERI
Middle Name:
Last Name:HURLBURT
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 1:40 E STATE ST
Mailing Address - Street 2:
Mailing Address - City:MOUNT MORRIS
Mailing Address - State:NY
Mailing Address - Zip Code:14510-9727
Mailing Address - Country:US
Mailing Address - Phone:585-658-9498
Mailing Address - Fax:585-658-9127
Practice Address - Street 1:40 E STATE ST
Practice Address - Street 2:
Practice Address - City:MOUNT MORRIS
Practice Address - State:NY
Practice Address - Zip Code:14510-9727
Practice Address - Country:US
Practice Address - Phone:585-658-9498
Practice Address - Fax:585-658-9127
Is Sole Proprietor?:No
Enumeration Date:2007-11-28
Last Update Date:2007-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY043420183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist