Provider Demographics
NPI:1336490432
Name:BERKOMPAS, ASHLEY NICOLE (PHARM D)
Entity Type:Individual
Prefix:DR
First Name:ASHLEY
Middle Name:NICOLE
Last Name:BERKOMPAS
Suffix:
Gender:F
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:179 HANCOCK ST
Mailing Address - Street 2:
Mailing Address - City:GALLATIN
Mailing Address - State:TN
Mailing Address - Zip Code:37066-6346
Mailing Address - Country:US
Mailing Address - Phone:615-527-0456
Mailing Address - Fax:615-527-0454
Practice Address - Street 1:179 HANCOCK ST
Practice Address - Street 2:
Practice Address - City:GALLATIN
Practice Address - State:TN
Practice Address - Zip Code:37066-6346
Practice Address - Country:US
Practice Address - Phone:615-527-0456
Practice Address - Fax:615-527-0454
Is Sole Proprietor?:No
Enumeration Date:2012-09-28
Last Update Date:2012-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN35873183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist