Mr Thomas Richard Berg, RPH is a
Indian Health Service/tribal/urban Indian Health (i/t/u) Pharmacy based in Inchelium, Washington. Mr Thomas Richard Berg is licensed to practice in Washington (license number CF00003827) and his current practice location is
39 Shortcut Road, Inchelium, Washington. He can be reached at his office (for appointments etc.) via phone at
(509) 722-7009.
NPI number for Mr Thomas Richard Berg is 1255485355 and his current mailing address is Po Box 290, Inchelium, Washington. He
does not participate in medicare program and thus does not accept medicare assignments. His NPI Number is 1255485355.
Healthcare Provider's Profile
| Full Name | Mr Thomas Richard Berg |
|---|
| Gender | Male |
|---|
| Speciality | Indian Health Service/tribal/urban Indian Health (i/t/u) Pharmacy |
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| Location | 39 Shortcut Road, Inchelium, Washington |
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| Accepts Medicare Assignments | Does not participate in Medicare Program. He may not accept medicare assignment. |
|---|
NPI Data:
- NPI Number: 1255485355
- Provider Enumeration Date: 01/23/2007
- Last Update Date: 07/08/2007
Medical Identifiers
Medical identifiers for Mr Thomas Richard Berg such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1255485355 | NPI | - | NPPES |
| 4924735 | Other | WA | NABP |
| CF00003827 | Other | WA | PHARMACY LICENSE |
| 6008767 | Medicaid | WA | |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 183500000X | Pharmacist | 4214 (South Dakota) | Primary |
| 332800000X | Indian Health Service/tribal/urban Indian Health (i/t/u) Pharmacy | CF00003827 (Washington) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Mr Thomas Richard Berg is
NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
|---|
Mr Thomas Richard Berg, RPH
Po Box 290,
Inchelium, WA 99138-0290
Ph: (509) 722-7009 | Mr Thomas Richard Berg, RPH
39 Shortcut Road,
Inchelium, WA 99138-0290
Ph: (509) 722-7009 |
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