Healthcare Provider Details
I. General information
NPI: 1578997292
Provider Name (Legal Business Name): HERCARE INC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 08/29/2013
Last Update Date: 09/04/2013
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
#1 ESTATE CANE SUNSHINE MALL SUITE 205
FREDERIKSTED VI
00840
US
IV. Provider business mailing address
PO BOX 216
CHRISTIANSTED VI
00821-0216
US
V. Phone/Fax
- Phone: 340-773-0007
- Fax: 340-772-5755
- Phone: 340-773-0007
- Fax: 340-772-5755
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207V00000X |
| Taxonomy | Obstetrics & Gynecology Physician |
| License Number | 1153 |
| License Number State | VI |
VIII. Authorized Official
Name: DR.
MICHELE
BARBARA
BERKELEY
Title or Position: PRESIDENT
Credential: M.D.
Phone: 340-277-1003