Douglas Allan Berry
Individual provider Active NPI Pharmacist · Delaware, OH
NPI 1912324922 · NPPES record last updated Mar 27, 2014
Key facts
- NPI
- 1912324922
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pharmacist 183500000X
- License
- 03216365 (OH)
- Practice address
- 1860 White Oak Dr
Delaware, OH 43015-9271 - Phone
- (740) 938-4130
- Fax
- (740) 938-4131
- NPI assigned
- Mar 27, 2014
- Sex
- Male
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 19050 | FL | MD | Pharmacist |
| 011684 | GA | MD | Pharmacist |
| 042581 | NY | MD | Pharmacist |
| 1487740 | WI | MD | Pharmacist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 03216365 | OH | Yes |
| Pharmacist | 183500000X | 19050 | FL | |
| Pharmacist | 183500000X | 011684 | GA | |
| Pharmacist | 183500000X | 042581 | NY | |
| Pharmacist | 183500000X | 1487740 | WI |
Addresses
Primary practice location
1860 White Oak Dr
Delaware, OH 43015-9271
Mailing address
1860 White Oak Dr
Delaware, OH 43015-9271
Phone (740) 938-4130
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 011684 | Other | GA | PHARMACIST |
| 1487740 | Other | WI | PHARMACIST |
| PS19050 | Other | FL | PHARMACIST |
| 042581 | Other | NY | PHARMACIST |
| 03216365 | Other | OH | PHARMACIST |
Other providers in Delaware, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 27, 2014. 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.