Sherry Childers
Individual provider Active NPI Pharmacist · Herrin, IL
NPI 1972052645 · NPPES record last updated Sep 23, 2016
Key facts
- NPI
- 1972052645
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pharmacist 183500000X
- License
- 051039434 (IL)
- Practice address
- 1713 S Park Ave
Herrin, IL 62948-4166 - Phone
- (618) 942-6641
- Fax
- (618) 988-9306
- NPI assigned
- Sep 23, 2016
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 2
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 051039434 | IL | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Walmart Inc. | Past | Accepting new patients | |
| Walmart Inc. | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 051039434 | IL | Yes |
Addresses
Primary practice location
1713 S Park Ave
Herrin, IL 62948-4166
Mailing address
5 Quail Dr
Herrin, IL 62948-2473
Phone (618) 694-9953
Other providers in Herrin, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 23, 2016. 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.