Provider Demographics
NPI:1154733780
Name:BORIS, SHERYL (RPH)
Entity type:Individual
Prefix:
First Name:SHERYL
Middle Name:
Last Name:BORIS
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 1:2735 W TIPPECANOE TRL
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85745-1005
Mailing Address - Country:US
Mailing Address - Phone:760-505-7141
Mailing Address - Fax:
Practice Address - Street 1:2735 W TIPPECANOE TRL
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85745-1005
Practice Address - Country:US
Practice Address - Phone:760-505-7141
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-06-02
Last Update Date:2014-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZS0009857183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist