Provider Demographics
NPI:1356521967
Name:GREER, ANGELA CHERWYN (PHARMD)
Entity type:Individual
Prefix:DR
First Name:ANGELA
Middle Name:CHERWYN
Last Name:GREER
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 1:3334 HOLLYWOOD AVE
Mailing Address - Street 2:
Mailing Address - City:JACKSON
Mailing Address - State:MS
Mailing Address - Zip Code:39213-6755
Mailing Address - Country:US
Mailing Address - Phone:601-366-7919
Mailing Address - Fax:
Practice Address - Street 1:3334 HOLLYWOOD AVE
Practice Address - Street 2:
Practice Address - City:JACKSON
Practice Address - State:MS
Practice Address - Zip Code:39213-6755
Practice Address - Country:US
Practice Address - Phone:601-366-7919
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-11-12
Last Update Date:2007-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MSE-010302183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist