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NPI Code Detail

MEDICARE: RACHEL BERREY RPH

MEDICARE: RACHEL BERREY 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
1183500000XPharmacistPS0020667FL

General Provider Information

NPI Number : 1790071611
Entity Type Code : Individual
Provider Name (Legal Business Name) : RACHEL BERREY RPH
Provider Business Mailing Address
First Line : 2750 W NEW HAVEN AVE
Second Line : T-0689
City : MELBOURNE
State : FL
Zip : 32904-3706
Country : US
Telephone Number : 321-722-9262
Fax Number : 321-722-9262
Provider Business Practice Location Address
First Line : 2750 W NEW HAVEN AVE
Second Line : T-0689
City : MELBOURNE
State : FL
Zip : 32904-3706
Country : US
Telephone Number : 321-722-9262
Fax Number : 321-722-9262
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/20/2011
Last Update Date : 06/20/2011

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