Organization Active NPI

Berry Pharmacy and Wellness Services LLC

Doing business as West Bend Pharmacy

  • Community/Retail Pharmacy
  • West Bend, WI
National Provider Identifier
1871683045
Registry record updated Nov 23, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
879242 Issued in WI
Legal business name
BERRY PHARMACY AND WELLNESS SERVICES LLC
Doing business as
West Bend Pharmacy
Practice address
1709 S 18TH Ave
West Bend, WI 53095-7808
Phone
(262) 338-6444
Fax
(262) 338-3635
NPI assigned
Oct 16, 2006
Last updated
Nov 23, 2010By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 23, 2010

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

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Retail Pharmacy 3336C0003X 879242 WI Primary

Addresses

Primary practice location

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

Mailing address

PO Box 553
West Bend, WI 53095-0553
Phone (262) 338-6444

Other names 1

  • WEST BEND PHARMACY Doing business as

National Provider Directory

National Provider Directory

NPI Registry JSON

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": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "WEST BEND PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in West Bend, WI

Sources for this page

  • 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.