Provider Demographics
NPI:1255404497
Name:SHERROD, JEREMY E (PHARMD)
Entity type:Individual
Prefix:
First Name:JEREMY
Middle Name:E
Last Name:SHERROD
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:153 CLEARVIEW ST
Mailing Address - Street 2:
Mailing Address - City:RUTLEDGE
Mailing Address - State:TN
Mailing Address - Zip Code:37861
Mailing Address - Country:US
Mailing Address - Phone:865-828-5507
Mailing Address - Fax:
Practice Address - Street 1:602 E BROADWAY
Practice Address - Street 2:
Practice Address - City:NEWPORT
Practice Address - State:TN
Practice Address - Zip Code:37821
Practice Address - Country:US
Practice Address - Phone:423-623-3088
Practice Address - Fax:423-623-0777
Is Sole Proprietor?:No
Enumeration Date:2006-11-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNTN8524183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist