Provider Demographics
NPI:1083466312
Name:BERKLEY PHARMACY MI LLC
Entity Type:Organization
Organization Name:BERKLEY PHARMACY MI LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:HEMA
Authorized Official - Middle Name:M
Authorized Official - Last Name:PATEL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:248-552-6600
Mailing Address - Street 1:28577 SCHOENHERR RD
Mailing Address - Street 2:
Mailing Address - City:WARREN
Mailing Address - State:MI
Mailing Address - Zip Code:48088-4330
Mailing Address - Country:US
Mailing Address - Phone:586-573-8300
Mailing Address - Fax:576-573-8301
Practice Address - Street 1:28577 SCHOENHERR RD
Practice Address - Street 2:
Practice Address - City:WARREN
Practice Address - State:MI
Practice Address - Zip Code:48088-4330
Practice Address - Country:US
Practice Address - Phone:586-573-8300
Practice Address - Fax:576-573-8301
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-04-02
Last Update Date:2024-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336L0003XSuppliersPharmacyLong Term Care Pharmacy