Provider Demographics
NPI:1952697823
Name:SCUDDER, SHARI R (BS, PHARMD)
Entity Type:Individual
Prefix:MRS
First Name:SHARI
Middle Name:R
Last Name:SCUDDER
Suffix:
Gender:F
Credentials:BS, PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:240 MARKET DRIVE
Mailing Address - Street 2:TARGET PHARMACY
Mailing Address - City:ELYRIA
Mailing Address - State:OH
Mailing Address - Zip Code:44035
Mailing Address - Country:US
Mailing Address - Phone:440-324-2339
Mailing Address - Fax:440-324-2339
Practice Address - Street 1:240 MARKET DR
Practice Address - Street 2:TARGET PHARMACY
Practice Address - City:ELYRIA
Practice Address - State:OH
Practice Address - Zip Code:44035-2886
Practice Address - Country:US
Practice Address - Phone:440-324-2339
Practice Address - Fax:440-324-2339
Is Sole Proprietor?:Yes
Enumeration Date:2011-06-20
Last Update Date:2011-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH03326691183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist