Sherry Theologos, RPH
Individual provider Active NPI Pharmacist · Waveland, MS
NPI 1154723906 · NPPES record last updated Sep 24, 2014
Key facts
- NPI
- 1154723906
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pharmacist 183500000X
- License
- E07429 (MS)
- Practice address
- 460 Highway 90
Waveland, MS 39576-2508 - Phone
- (228) 467-4717
- Fax
- (228) 467-1061
- NPI assigned
- Sep 24, 2014
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- Credentials
- Registered Pharmacist
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| E07429 | MS | MD | Pharmacist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | E07429 | MS | Yes |
Addresses
Primary practice location
460 Highway 90
Waveland, MS 39576-2508
Mailing address
460 Highway 90
Waveland, MS 39576-2508
Phone (228) 467-4717
Other providers in Waveland, MS
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 24, 2014. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.