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NPI Code Detail

MEDICARE: BRANDI BERG RPH

MEDICARE: BRANDI BERG RPH
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1183500000XPharmacist63001MT

General Provider Information

NPI Number : 1588214886
Entity Type Code : Individual
Provider Name (Legal Business Name) : BRANDI BERG RPH
Provider Business Mailing Address
First Line : 2301 10TH AVE S
Second Line :
City : GREAT FALLS
State : MT
Zip : 59405-2967
Country : US
Telephone Number : 406-727-1376
Fax Number :
Provider Business Practice Location Address
First Line : 2301 10TH AVE S
Second Line :
City : GREAT FALLS
State : MT
Zip : 59405-2967
Country : US
Telephone Number : 406-727-1376
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/18/2019
Last Update Date : 09/18/2019

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Directions to “ BRANDI BERG RPH” Practice Location

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