Healthcare Provider Details

I. General information

NPI: 1003843236
Provider Name (Legal Business Name): JOSEPH C BIERY JR. PHARMD, CGP
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/26/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

EDWARD J. HINES VAH ; PHARMACY SERVICES (M/C 181) 5TH AVE & ROOSEVELT RD
HINES IL
60141
US

IV. Provider business mailing address

904 S HILLSIDE AVE
ELMHURST IL
60126-4922
US

V. Phone/Fax

Practice location:
  • Phone: 708-202-8387
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number11995
License Number StateNV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: