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General NPI Number Information
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NPI Number | 1275684151
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Entity Type | Individual
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Provider Name | BRIAN GRAYSON BERRY PHARM.D
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Gender | Male
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Dates
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Enumeration Date | 01/16/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 3378 COBB PARKWAY NW
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City | ACWORTH
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State | GA
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Zip | 30101
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Country | US
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Telephone | 678-202-0997
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Fax | 678-202-0997
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Provider Business Mailing Address
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Address Line | 724 RIDGE RD
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City | CANTON
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State | GA
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Zip | 30114-4168
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Country | US
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Telephone | 540-230-6189
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Fax |
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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 | RPH022493
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License Number State | GA
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Taxonomy #2
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 16098
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License Number State | MD
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Taxonomy #3
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 10373
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License Number State | SC
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