Thomas Richard Berg, R.PH.
Individual provider Active NPI Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy · Inchelium, WA
NPI 1255485355 · NPPES record last updated Sep 11, 2025
Key facts
- NPI
- 1255485355
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy 332800000X
- License
- CF00003827 (WA)
- Practice address
- 39 Shortcut Road
Inchelium, WA 99138-0290 - Phone
- (509) 722-7009
- Fax
- (509) 722-7021
- NPI assigned
- Jan 23, 2007
- Sex
- Male
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- Credentials
- Registered Pharmacist
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4214 | SD | MD | Pharmacist |
| CF00003827 | WA | MD | Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 4214 | SD | |
| Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy | 332800000X | CF00003827 | WA | Yes |
Addresses
Primary practice location
39 Shortcut Road
Inchelium, WA 99138-0290
Mailing address
PO Box 290
Inchelium, WA 99138-0290
Phone (509) 722-7009
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 4924735 | Other | WA | NABP |
| CF00003827 | Other | WA | PHARMACY LICENSE |
| 6008767 | Medicaid | WA |
Other providers in Inchelium, WA
- Larry Joe Abell
- Karri Askerlund
- Jennifer Barr-Clendennen
- Nessamarie Eueva Bates
- Arielle Anastasia Cawston
- Colvile Nations Community Health Centers
- Colville Nation Community Health Center
- Colville Nation Community Health Centers
- Colville Nation Community Health Centers
All providers in Inchelium, WA · Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy in Washington
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 11, 2025. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.