Provider Demographics
NPI:1194155440
Name:DISMUKE, SHERREE (PHARM D)
Entity type:Individual
Prefix:
First Name:SHERREE
Middle Name:
Last Name:DISMUKE
Suffix:
Gender:F
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5084 CATHAY CT
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80249-8436
Mailing Address - Country:US
Mailing Address - Phone:720-435-1588
Mailing Address - Fax:
Practice Address - Street 1:2190 E 18TH AVE
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80206-1128
Practice Address - Country:US
Practice Address - Phone:303-388-1674
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-11-23
Last Update Date:2013-11-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO19905183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist