Provider Demographics
NPI:1932532918
Name:CANNINGTON, SHERYL P (R PH)
Entity Type:Individual
Prefix:
First Name:SHERYL
Middle Name:P
Last Name:CANNINGTON
Suffix:
Gender:F
Credentials:R PH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2490 CANNINGTON RD
Mailing Address - Street 2:
Mailing Address - City:IRON CITY
Mailing Address - State:GA
Mailing Address - Zip Code:39859-3615
Mailing Address - Country:US
Mailing Address - Phone:229-774-2532
Mailing Address - Fax:
Practice Address - Street 1:409 W 3RD ST
Practice Address - Street 2:
Practice Address - City:DONALSONVILLE
Practice Address - State:GA
Practice Address - Zip Code:39845-1511
Practice Address - Country:US
Practice Address - Phone:229-524-2596
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-08-14
Last Update Date:2013-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA11156183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA11156OtherLICENSE