Provider Demographics
NPI:1528771565
Name:SHEEHY, JEREMIAH JOSEPH IV (PHARMD)
Entity type:Individual
Prefix:DR
First Name:JEREMIAH
Middle Name:JOSEPH
Last Name:SHEEHY
Suffix:IV
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4142 E THISTLE LANDING DR
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85044-6718
Mailing Address - Country:US
Mailing Address - Phone:716-200-7033
Mailing Address - Fax:
Practice Address - Street 1:4142 E THISTLE LANDING DR
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85044-6718
Practice Address - Country:US
Practice Address - Phone:716-200-7033
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-01-04
Last Update Date:2023-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZS024951183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist