Provider Demographics
NPI:1356640411
Name:BERKEY, KARL GENE (RPH)
Entity Type:Individual
Prefix:MR
First Name:KARL
Middle Name:GENE
Last Name:BERKEY
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:900 W STEIN HWY
Mailing Address - Street 2:
Mailing Address - City:SEAFORD
Mailing Address - State:DE
Mailing Address - Zip Code:19973-1208
Mailing Address - Country:US
Mailing Address - Phone:302-629-6686
Mailing Address - Fax:302-628-1297
Practice Address - Street 1:900 W STEIN HWY
Practice Address - Street 2:
Practice Address - City:SEAFORD
Practice Address - State:DE
Practice Address - Zip Code:19973-1208
Practice Address - Country:US
Practice Address - Phone:302-629-6686
Practice Address - Fax:302-628-1297
Is Sole Proprietor?:No
Enumeration Date:2011-03-15
Last Update Date:2011-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEA1-0001741183500000X
MD09246183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist