Provider Demographics
NPI:1548255383
Name:DURRENCE, SHARON B (RPH)
Entity type:Individual
Prefix:MRS
First Name:SHARON
Middle Name:B
Last Name:DURRENCE
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 1:15214 HIGHWAY 301
Mailing Address - Street 2:
Mailing Address - City:GLENNVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30427-8308
Mailing Address - Country:US
Mailing Address - Phone:912-654-3224
Mailing Address - Fax:912-654-3224
Practice Address - Street 1:15214 HIGHWAY 301
Practice Address - Street 2:
Practice Address - City:GLENNVILLE
Practice Address - State:GA
Practice Address - Zip Code:30427-8308
Practice Address - Country:US
Practice Address - Phone:912-654-3224
Practice Address - Fax:912-654-3224
Is Sole Proprietor?:No
Enumeration Date:2005-09-19
Last Update Date:2007-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA14108183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist