Active NPI
Laurel Lacey Berry, RPH
- Pharmacist
- Sylvania, AL
National Provider Identifier
1174830970
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 13916
- Practice address
- 14 Industrial LN
Sylvania, AL 35988-2273 - Phone
- (256) 638-6070
- NPI assigned
- Sep 1, 2010
- Last updated
- Sep 1, 2010
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 13916 | AL | Primary |
| Pharmacist | 183500000X | 9754 | TN | |
| Pharmacist | 183500000X | 20116 | GA |
Addresses
Primary practice location
14 Industrial LN
Sylvania, AL 35988-2273
Mailing address
14 Industrial LN
Sylvania, AL 35988-2273
Phone (256) 638-6070
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Registered Pharmacist
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 13916 | AL | MD | Pharmacist |
| 20116 | GA | MD | Pharmacist |
| 9754 | TN | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Wilco Drugs LLC | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1283299200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1283299200000",
"number": "1174830970",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "14 INDUSTRIAL LN",
"city": "SYLVANIA",
"state": "AL",
"postal_code": "359882273",
"telephone_number": "256-638-6070"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "14 INDUSTRIAL LN",
"city": "SYLVANIA",
"state": "AL",
"postal_code": "359882273",
"telephone_number": "256-638-6070"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BERRY",
"first_name": "LAUREL",
"middle_name": "LACEY",
"name_prefix": "Mrs.",
"credential": "RPH",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2010-09-01",
"last_updated": "2010-09-01",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "AL",
"license": "13916",
"primary": true
},
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "TN",
"license": "9754",
"primary": false
},
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "GA",
"license": "20116",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Sylvania, AL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 1, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.