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General NPI Number Information
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NPI Number | 1811735699
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Entity Type | Individual
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Provider Name | ALLISON ANN-ELIZABETH BERRYMAN PHARMD, RPH
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Gender | Female
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Dates
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Enumeration Date | 07/17/2024
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Last Update Date | 07/17/2024
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Provider Practice Location Address
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Address Line | 11109 PARKVIEW PLAZA DR
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City | FORT WAYNE
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State | IN
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Zip | 46845-1701
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Country | US
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Telephone | 260-266-4400
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Fax |
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Provider Business Mailing Address
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Address Line | 18270 WETZEL RD
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City | MIDDLE POINT
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State | OH
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Zip | 45863-9559
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Country | US
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Telephone | 419-203-2255
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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 | 03443752
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License Number State | OH
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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 | 26030382A
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License Number State | IN
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