Marianne Bergs
Individual provider Active NPI Pharmacist · Eagle River, WI
NPI 1376155176 · NPPES record last updated Sep 4, 2020
Key facts
- NPI
- 1376155176
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pharmacist 183500000X
- License
- 10156 (WI)
- Practice address
- 123 E Wall St
Eagle River, WI 54521-9550 - Phone
- (715) 479-7430
- NPI assigned
- Aug 21, 2020
- Sex
- Female
- 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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 10156 | WI | MD | Certified Registered Nurse Anesthetist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 10156 | WI | Yes |
Addresses
Primary practice location
123 E Wall St
Eagle River, WI 54521-9550
Mailing address
PO Box 2013
Woodruff, WI 54568-2013
Other providers in Eagle River, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 4, 2020. 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.