Rick Bergeron

Individual provider Active NPI Pharmacist · Onley, VA

NPI 1740693753 · NPPES record last updated Jun 6, 2014

Key facts

NPI
1740693753
Entity type
Individual (NPI type 1)
Primary specialty
Pharmacist 183500000X
License
0202208491 (VA)
Practice address
25096 Lankford Highway
Onley, VA 23418
Phone
(757) 787-7154
NPI assigned
Jun 6, 2014
Sex
Male
Sole proprietor
No

Medicare participation

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

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
0202208491VAMDPharmacist

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 0202208491 VA Yes

Addresses

Primary practice location

25096 Lankford Highway
Onley, VA 23418

Mailing address

12151 Nandua Shores Dr
Painter, VA 23420-3222
Phone (757) 710-8526

Other providers in Onley, VA

All providers in Onley, VA · Pharmacist in Virginia

Sources for this page

Verify at the official NPI Registry.