Provider Demographics
NPI:1447604988
Name:BERRY, TWILA (PHARMACIST)
Entity Type:Individual
Prefix:MRS
First Name:TWILA
Middle Name:
Last Name:BERRY
Suffix:
Gender:F
Credentials:PHARMACIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8050 PANTHER CREEK RD
Mailing Address - Street 2:
Mailing Address - City:CHRISTIANA
Mailing Address - State:TN
Mailing Address - Zip Code:37037-5142
Mailing Address - Country:US
Mailing Address - Phone:615-896-6523
Mailing Address - Fax:
Practice Address - Street 1:8050 PANTHER CREEK RD
Practice Address - Street 2:
Practice Address - City:CHRISTIANA
Practice Address - State:TN
Practice Address - Zip Code:37037-5142
Practice Address - Country:US
Practice Address - Phone:615-896-6523
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-04-21
Last Update Date:2016-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN6787183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist