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General NPI Number Information
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NPI Number | 1396713921
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Entity Type | Individual
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Provider Name | FREDERICK MORGAN BERNEKING PHARM. D.
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Gender | Male
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Dates
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Enumeration Date | 03/09/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 1717 W RIDGEWAY AVE SUITE 50A
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City | WATERLOO
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State | IA
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Zip | 50701-4543
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Country | US
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Telephone | 319-833-5838
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Fax |
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Provider Business Mailing Address
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Address Line | 417 LOMA ST
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City | WATERLOO
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State | IA
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Zip | 50701-5606
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Country | US
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Telephone | 319-232-1375
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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 | 1835P1200X
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Taxonomy Name | Pharmacotherapy Pharmacist
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License Number | 15397
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License Number State | IA
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