Provider Demographics
NPI:1427153907
Name:KIRBY, SHEROYL MARIE (RPH)
Entity type:Individual
Prefix:
First Name:SHEROYL
Middle Name:MARIE
Last Name:KIRBY
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 1:13041 MOHNEY LAKE RD
Mailing Address - Street 2:
Mailing Address - City:THREE RIVERS
Mailing Address - State:MI
Mailing Address - Zip Code:49093-9712
Mailing Address - Country:US
Mailing Address - Phone:269-244-1333
Mailing Address - Fax:269-279-9180
Practice Address - Street 1:808 W MICHIGAN AVE
Practice Address - Street 2:
Practice Address - City:THREE RIVERS
Practice Address - State:MI
Practice Address - Zip Code:49093-3103
Practice Address - Country:US
Practice Address - Phone:269-278-2355
Practice Address - Fax:269-279-9180
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-13
Last Update Date:2017-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5302411013183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist