Provider Demographics
NPI:1013675545
Name:JOSEPH, SHERINE R (RPH)
Entity Type:Individual
Prefix:MRS
First Name:SHERINE
Middle Name:R
Last Name:JOSEPH
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 1:4109 ANNAPOLIS RD
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21227-3605
Mailing Address - Country:US
Mailing Address - Phone:410-636-1035
Mailing Address - Fax:866-736-0213
Practice Address - Street 1:4109 ANNAPOLIS RD
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21227-3605
Practice Address - Country:US
Practice Address - Phone:410-636-1035
Practice Address - Fax:866-736-0213
Is Sole Proprietor?:No
Enumeration Date:2021-12-01
Last Update Date:2021-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD167281835P0018X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P0018XPharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD021520100Medicaid