Provider Demographics
NPI:1497589980
Name:GRANT, CHEYANNE ROSE (PHARMD)
Entity type:Individual
Prefix:
First Name:CHEYANNE
Middle Name:ROSE
Last Name:GRANT
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:CHEYANNE
Other - Middle Name:ROSE
Other - Last Name:KARALUS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PHARMD
Mailing Address - Street 1:358 CLINTON ST
Mailing Address - Street 2:
Mailing Address - City:COWLESVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:14037-9747
Mailing Address - Country:US
Mailing Address - Phone:716-912-1445
Mailing Address - Fax:
Practice Address - Street 1:3740 MCKINLEY PKWY
Practice Address - Street 2:
Practice Address - City:BLASDELL
Practice Address - State:NY
Practice Address - Zip Code:14219-3097
Practice Address - Country:US
Practice Address - Phone:716-824-8013
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-08-28
Last Update Date:2024-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY070940183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist