Provider Demographics
NPI:1669548558
Name:BINGAMAN, SHERRY LEE (RPH)
Entity type:Individual
Prefix:
First Name:SHERRY
Middle Name:LEE
Last Name:BINGAMAN
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 1:861 SUNBURY RD
Mailing Address - Street 2:
Mailing Address - City:SHAMOKIN DAM
Mailing Address - State:PA
Mailing Address - Zip Code:17876-8927
Mailing Address - Country:US
Mailing Address - Phone:570-271-4536
Mailing Address - Fax:570-271-4537
Practice Address - Street 1:200 STATE HOSPITAL DR
Practice Address - Street 2:DANVILLE STATE HOSPITAL
Practice Address - City:DANVILLE
Practice Address - State:PA
Practice Address - Zip Code:17821-9103
Practice Address - Country:US
Practice Address - Phone:570-271-4536
Practice Address - Fax:570-271-4537
Is Sole Proprietor?:No
Enumeration Date:2006-11-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARP034943R183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist