Healthcare Provider Details
I. General information
NPI: 1477836278
Provider Name (Legal Business Name): BERGER ACUTE SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 09/28/2011
Last Update Date: 09/20/2012
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1470 S COURT ST
CIRCLEVILLE OH
43113-2165
US
IV. Provider business mailing address
4750 HEMPSTEAD STATION DR
KETTERING OH
45429-5164
US
V. Phone/Fax
- Phone: 800-875-0136
- Fax: 937-619-4150
- Phone: 800-875-0136
- Fax: 937-619-4150
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 208D00000X |
| Taxonomy | General Practice Physician |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 261Q00000X |
| Taxonomy | Clinic/Center |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: DR.
WILLIAM
COLE
Title or Position: MEDICAL DIRECTOR
Credential: MD
Phone: 800-875-0136