Provider Demographics
NPI:1699068874
Name:ROUGHTON, CHERRY NORRIS (RPH)
Entity type:Individual
Prefix:MRS
First Name:CHERRY
Middle Name:NORRIS
Last Name:ROUGHTON
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 1:8260 MARKET STREET
Mailing Address - Street 2:
Mailing Address - City:WILMINGTON
Mailing Address - State:NC
Mailing Address - Zip Code:28411
Mailing Address - Country:US
Mailing Address - Phone:910-686-1182
Mailing Address - Fax:910-686-9224
Practice Address - Street 1:8260 MARKET ST
Practice Address - Street 2:
Practice Address - City:WILMINGTON
Practice Address - State:NC
Practice Address - Zip Code:28411-9388
Practice Address - Country:US
Practice Address - Phone:910-686-1182
Practice Address - Fax:910-686-9224
Is Sole Proprietor?:No
Enumeration Date:2011-05-23
Last Update Date:2011-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC09650183500000X
SC6562183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist