Provider Demographics
NPI:1972103968
Name:SAM, SHERILIN ELSA (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:SHERILIN
Middle Name:ELSA
Last Name:SAM
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 1:1540 FAIRVIEW AVE
Mailing Address - Street 2:
Mailing Address - City:LANGHORNE
Mailing Address - State:PA
Mailing Address - Zip Code:19047-3707
Mailing Address - Country:US
Mailing Address - Phone:215-896-7698
Mailing Address - Fax:
Practice Address - Street 1:1000 FRANKLIN MILLS CIR
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19154-3115
Practice Address - Country:US
Practice Address - Phone:215-657-4709
Practice Address - Fax:215-657-4728
Is Sole Proprietor?:No
Enumeration Date:2020-10-28
Last Update Date:2023-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARP451030183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist