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General NPI Number Information
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NPI Number | 1205123627
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Entity Type | Individual
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Provider Name | BRIAN K BERGEY PHARMD, RPH
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Gender | Male
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Dates
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Enumeration Date | 07/06/2011
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Last Update Date | 10/02/2013
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Provider Practice Location Address
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Address Line | 1655 BUFFALO LAKE RD
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City | SANFORD
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State | NC
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Zip | 27332-2537
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Country | US
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Telephone | 919-498-1962
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Fax | 919-498-2077
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Provider Business Mailing Address
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Address Line | 1655 BUFFALO LAKE RD
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City | SANFORD
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State | NC
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Zip | 27332-2537
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Country | US
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Telephone | 919-498-1962
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Fax | 919-498-2077
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 21875
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License Number State | NC
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