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General NPI Number Information
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NPI Number | 1831134030
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Entity Type | Organization
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Legal Business Name | ST JOSEPH BEREA
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Dates
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Enumeration Date | 06/19/2006
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Last Update Date | 09/11/2025
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Provider Practice Location Address
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Address Line | 305 ESTILL ST
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City | BEREA
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State | KY
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Zip | 40403-1742
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Country | US
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Telephone | 859-986-6541
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Fax | 859-986-2697
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Provider Business Mailing Address
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Address Line | 305 ESTILL ST
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City | BEREA
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State | KY
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Zip | 40403-1742
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | PIC
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Name | JAMIE JONES
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Credential | RPH
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Telephone | 859-986-6541
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number | PO6847
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License Number State | KY
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Taxonomy #2
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Taxonomy Code | 3336I0012X
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Taxonomy Name | Institutional Pharmacy
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License Number |
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License Number State |
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