Susan Miller Bereck, R.PH
Individual provider Active NPI Pharmacist · Aurora, OH
NPI 1629364930 · NPPES record last updated Jun 24, 2011
Key facts
- NPI
- 1629364930
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pharmacist 183500000X
- License
- 03120910 (OH)
- Practice address
- 18855 N Market Place Dr
#2161
Aurora, OH 44202-8784 - Phone
- (330) 562-0637
- NPI assigned
- Jun 24, 2011
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 1
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 |
|---|---|---|---|
| 03120910 | OH | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| North Carolina CVS Pharmacy LLC | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 03120910 | OH | Yes |
Addresses
Primary practice location
18855 N Market Place Dr
#2161
Aurora, OH 44202-8784
Mailing address
18415 May Court
Chagrin Falls, OH 44023
Phone (440) 708-0082
Other providers in Aurora, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 24, 2011. 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.