Provider Demographics
NPI:1922755917
Name:PIENTKA, SHERYL DAWN (RPH)
Entity Type:Individual
Prefix:
First Name:SHERYL
Middle Name:DAWN
Last Name:PIENTKA
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:PO BOX 1480
Mailing Address - Street 2:
Mailing Address - City:POUND
Mailing Address - State:VA
Mailing Address - Zip Code:24279-1480
Mailing Address - Country:US
Mailing Address - Phone:276-926-6707
Mailing Address - Fax:276-926-4482
Practice Address - Street 1:342 MAIN ST
Practice Address - Street 2:
Practice Address - City:CLINTWOOD
Practice Address - State:VA
Practice Address - Zip Code:24228
Practice Address - Country:US
Practice Address - Phone:276-926-6707
Practice Address - Fax:276-926-4482
Is Sole Proprietor?:No
Enumeration Date:2022-03-09
Last Update Date:2022-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0202010475183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist