Provider Demographics
NPI:1053034918
Name:WOOD, CHERYL W
Entity type:Individual
Prefix:
First Name:CHERYL
Middle Name:W
Last Name:WOOD
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3397 PRESTWYCK LN
Mailing Address - Street 2:
Mailing Address - City:RICHFIELD
Mailing Address - State:OH
Mailing Address - Zip Code:44286-9065
Mailing Address - Country:US
Mailing Address - Phone:440-823-2825
Mailing Address - Fax:
Practice Address - Street 1:6720 BASS PRO DR
Practice Address - Street 2:
Practice Address - City:BOSTON HEIGHTS
Practice Address - State:OH
Practice Address - Zip Code:44236-1198
Practice Address - Country:US
Practice Address - Phone:330-341-7010
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-09-26
Last Update Date:2022-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH03312051183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist