Provider Demographics
NPI:1104946318
Name:SIMONE, SHARON LOUISE (RPH)
Entity type:Individual
Prefix:MS
First Name:SHARON
Middle Name:LOUISE
Last Name:SIMONE
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 1:191 KEILA AVE
Mailing Address - Street 2:
Mailing Address - City:LEWISBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17837-6834
Mailing Address - Country:US
Mailing Address - Phone:570-547-7950
Mailing Address - Fax:570-547-7710
Practice Address - Street 1:191 KEILA AVE
Practice Address - Street 2:
Practice Address - City:LEWISBURG
Practice Address - State:PA
Practice Address - Zip Code:17837-6834
Practice Address - Country:US
Practice Address - Phone:570-547-7950
Practice Address - Fax:570-547-7710
Is Sole Proprietor?:No
Enumeration Date:2007-03-30
Last Update Date:2024-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY010989183500000X
NC32826183500000X
PARP039861-L183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist