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NPI Code Detail

MEDICARE: DR. TIMOTHY BERG PHARMD

MEDICARE: DR. TIMOTHY BERG PHARMD
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
1183500000XPharmacist23715NC

General Provider Information

NPI Number : 1760813026
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. TIMOTHY BERG PHARMD
Provider Business Mailing Address
First Line : 809 PARK CENTER DR
Second Line : UNIT 305
City : MATTHEWS
State : NC
Zip : 28105-5047
Country : US
Telephone Number : 919-830-3271
Fax Number :
Provider Business Practice Location Address
First Line : 2325 VILLAGE LAKE DR
Second Line :
City : CHARLOTTE
State : NC
Zip : 28212-0081
Country : US
Telephone Number : 704-536-3663
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/11/2013
Last Update Date : 12/11/2013

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Directions to “ DR. TIMOTHY BERG PHARMD” Practice Location

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