MEDICARE: SAMSON BERHE 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
1	183500000X	Pharmacist	36643	TX

General Provider Information

NPI Number	:	1770263378
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SAMSON BERHE RPH

Provider Business Mailing Address
First Line	:	3535 N BUCKNER BLVD STE 106A
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75228-5633
Country	:	US
Telephone Number	:	214-321-3000
Fax Number	:	214-321-3015

Provider Business Practice Location Address
First Line	:	3535 N BUCKNER BLVD STE 106A
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75228-5633
Country	:	US
Telephone Number	:	214-321-3000
Fax Number	:	214-321-3015

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/19/2023
Last Update Date	:	10/02/2023

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Directions to “ SAMSON BERHE RPH” Practice Location

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