Provider Demographics
NPI:1265546998
Name:SHERMAN, SUE (RPH)
Entity type:Individual
Prefix:
First Name:SUE
Middle Name:
Last Name:SHERMAN
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 1:9578 ANGUS DR
Mailing Address - Street 2:
Mailing Address - City:SOUTH JORDAN
Mailing Address - State:UT
Mailing Address - Zip Code:84095-9523
Mailing Address - Country:US
Mailing Address - Phone:801-213-9250
Mailing Address - Fax:801-213-9255
Practice Address - Street 1:3730 W 4700 S
Practice Address - Street 2:
Practice Address - City:SALT LAKE CITY
Practice Address - State:UT
Practice Address - Zip Code:84118-3457
Practice Address - Country:US
Practice Address - Phone:801-213-9250
Practice Address - Fax:801-213-9255
Is Sole Proprietor?:No
Enumeration Date:2006-08-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT1528791701183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist