Kassandra Berg, PHARMD

Individual provider Active NPI Pharmacist · Travelers Rest, SC

NPI 1295463164 · NPPES record last updated Feb 3, 2023

Key facts

NPI
1295463164
Entity type
Individual (NPI type 1)
Primary specialty
Pharmacist 183500000X
License
43617 (SC)
Practice address
100 Little Texas Rd
Travelers Rest, SC 29690-9428
Phone
(864) 834-4451
NPI assigned
Aug 9, 2022
Sex
Female
Sole proprietor
Yes

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No
Credentials
Doctor of Pharmacy

State licenses

LicenseStateTypeSpecialty
43617SCMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Walgreen Co Current
since Aug 14, 2022
Accepting new patients
Walgreen Co Past
since Aug 14, 2022
Accepting new patients

Locations

100 Little Texas Rd
Travelers Rst, SC 29690
Phone (864) 834-4451

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 43617 SC Yes

Addresses

Primary practice location

100 Little Texas Rd
Travelers Rest, SC 29690-9428

Mailing address

100 Little Texas Rd
Travelers Rest, SC 29690-9428
Phone (864) 834-4451

Other providers in Travelers Rest, SC

All providers in Travelers Rest, SC · Pharmacist in South Carolina

Sources for this page

Verify at the official NPI Registry.