Healthcare Provider Details

I. General information

NPI: 1972853182
Provider Name (Legal Business Name): MARLA BERRY PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/14/2012
Last Update Date: 05/07/2026
Certification Date: 05/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1550 OAK RIDGE TPKE
OAK RIDGE TN
37830-6205
US

IV. Provider business mailing address

1550 OAK RIDGE TPKE
OAK RIDGE TN
37830-6205
US

V. Phone/Fax

Practice location:
  • Phone: 865-294-0215
  • Fax: 865-294-0219
Mailing address:
  • Phone: 865-294-0215
  • Fax: 865-294-0219

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number36851
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: