Provider Demographics
NPI:1487937868
Name:MATTHEWS, CHERRIE SIMS (RPH)
Entity type:Individual
Prefix:
First Name:CHERRIE
Middle Name:SIMS
Last Name:MATTHEWS
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 1:9194 MANSFIELD RD
Mailing Address - Street 2:
Mailing Address - City:SHREVEPORT
Mailing Address - State:LA
Mailing Address - Zip Code:71118-3123
Mailing Address - Country:US
Mailing Address - Phone:318-687-7272
Mailing Address - Fax:318-686-9709
Practice Address - Street 1:9194 MANSFIELD RD
Practice Address - Street 2:
Practice Address - City:SHREVEPORT
Practice Address - State:LA
Practice Address - Zip Code:71118-3123
Practice Address - Country:US
Practice Address - Phone:318-687-7272
Practice Address - Fax:318-686-9709
Is Sole Proprietor?:Yes
Enumeration Date:2011-09-22
Last Update Date:2011-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA11814183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist