Provider Demographics
NPI:1447360722
Name:SHERMAN, ROGER FLOYD (RPH)
Entity type:Individual
Prefix:MR
First Name:ROGER
Middle Name:FLOYD
Last Name:SHERMAN
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:470 CANTON ST
Mailing Address - Street 2:
Mailing Address - City:TROY
Mailing Address - State:PA
Mailing Address - Zip Code:16947-1410
Mailing Address - Country:US
Mailing Address - Phone:570-297-5400
Mailing Address - Fax:570-297-5401
Practice Address - Street 1:470 CANTON ST
Practice Address - Street 2:
Practice Address - City:TROY
Practice Address - State:PA
Practice Address - Zip Code:16947-1410
Practice Address - Country:US
Practice Address - Phone:570-297-5400
Practice Address - Fax:570-297-5401
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARP041826L183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PARP041826LOtherPA PHARMACIST LICENSE