Individual provider Active NPI

Edmund Stefan Berchert III, RPH

  • Pharmacist
  • Brunswick, OH
National Provider Identifier
1811125271
Registry record updated Jun 24, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
03120456 Issued in OH
Practice address
3688 Center Rd
Brunswick, OH 44212-3620
Phone
(330) 225-0202
Fax
(330) 273-1876
NPI assigned
Jun 24, 2009
Last updated
Jun 24, 2009By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 24, 2009

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 03120456 OH Primary

Addresses

Primary practice location

3688 Center Rd
Brunswick, OH 44212-3620

Mailing address

3688 Center Rd
Brunswick, OH 44212-3620
Phone (330) 225-0202

Medicare participation

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

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Registered Pharmacist

State licenses

LicenseStateTypeSpecialty
03120456OHMDPharmacist

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1245801600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1245801600000",
    "number": "1811125271",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3688 CENTER RD",
            "city": "BRUNSWICK",
            "state": "OH",
            "postal_code": "442123620",
            "telephone_number": "330-225-0202",
            "fax_number": "330-273-1876"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3688 CENTER RD",
            "city": "BRUNSWICK",
            "state": "OH",
            "postal_code": "442123620",
            "telephone_number": "330-225-0202",
            "fax_number": "330-273-1876"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BERCHERT",
        "first_name": "EDMUND",
        "middle_name": "STEFAN",
        "name_suffix": "III",
        "credential": "RPH",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-06-24",
        "last_updated": "2009-06-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "OH",
            "license": "03120456",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brunswick, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 24, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.