Berry Pharmacy and Wellness Services LLC

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

879242 Issued in WI

Legal business name

BERRY PHARMACY AND WELLNESS SERVICES LLC

Practice address

1709 S 18TH Ave
West Bend, WI 53095-7808

Phone

(262) 338-6444

Fax

(262) 338-3635

NPI assigned

Oct 16, 2006

Organization subpart

No

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

Authorized official

Name

Douglas Berry, RPH

Title

President

Phone

(262) 338-6444

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• WEST BEND PHARMACY Doing business as

Locations

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

{
    "created_epoch": "1160956800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1290470400000",
    "number": "1871683045",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 553",
            "city": "WEST BEND",
            "state": "WI",
            "postal_code": "530950553",
            "telephone_number": "262-338-6444",
            "fax_number": "262-338-3635"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1709 S 18TH AVE",
            "city": "WEST BEND",
            "state": "WI",
            "postal_code": "530957808",
            "telephone_number": "262-338-6444",
            "fax_number": "262-338-3635"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BERRY PHARMACY AND WELLNESS SERVICES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-16",
        "last_updated": "2010-11-23",
        "status": "A",
        "authorized_official_last_name": "BERRY",
        "authorized_official_first_name": "DOUGLAS",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "262-338-6444",
        "authorized_official_credential": "RPH"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "WI",
            "license": "879242",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCPDP PROVIDER IDENTIFICATION NUMBER",
            "identifier": "5110515",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "36222100",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "WEST BEND PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Benevolent Corporation Cedar Community
• Benevolent Corporation Cedar Community
• Robin L Berk, PHARMD
• Amy A Berken, PT
• Kenneth Moses Bero Jr., DDS
• Maisha Berry-Hooks, M.D.
• Kelleigh Best
• Penny Nickel Biersach
• Todd Michael Biesterfeld, MPT
• Monica Katherine Binder, DNP, APNP, FNP-BC

• Community/Retail Pharmacy in West Bend, WI
• Providers in West Bend, WI by specialty
• Community/Retail Pharmacy in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 23, 2010; 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.