Provider Demographics
NPI:1225880404
Name:BERKEREY, LAURA (RPH)
Entity Type:Individual
Prefix:
First Name:LAURA
Middle Name:
Last Name:BERKEREY
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:25 S ALEXANDER ST
Mailing Address - Street 2:
Mailing Address - City:FARMINGTON
Mailing Address - State:MO
Mailing Address - Zip Code:63640-2903
Mailing Address - Country:US
Mailing Address - Phone:618-719-6304
Mailing Address - Fax:
Practice Address - Street 1:806 VALLEY CREEK DR
Practice Address - Street 2:
Practice Address - City:FARMINGTON
Practice Address - State:MO
Practice Address - Zip Code:63640-1969
Practice Address - Country:US
Practice Address - Phone:573-747-1191
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-04-02
Last Update Date:2024-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO20050003021835P2201X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P2201XPharmacy Service ProvidersPharmacistAmbulatory Care