Provider Demographics
NPI:1013217108
Name:ROSE, SHERYL (PHARMD)
Entity Type:Individual
Prefix:
First Name:SHERYL
Middle Name:
Last Name:ROSE
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 1:1031 NEVADA HWY
Mailing Address - Street 2:
Mailing Address - City:BOULDER CITY
Mailing Address - State:NV
Mailing Address - Zip Code:89005-1815
Mailing Address - Country:US
Mailing Address - Phone:702-293-6347
Mailing Address - Fax:702-293-6274
Practice Address - Street 1:1031 NEVADA HWY
Practice Address - Street 2:
Practice Address - City:BOULDER CITY
Practice Address - State:NV
Practice Address - Zip Code:89005-1815
Practice Address - Country:US
Practice Address - Phone:702-293-6347
Practice Address - Fax:702-293-6274
Is Sole Proprietor?:No
Enumeration Date:2010-10-24
Last Update Date:2010-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV17167183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist