Provider Demographics
NPI:1619248630
Name:VERLING, VERN RAYMOND (PHARMD)
Entity Type:Individual
Prefix:
First Name:VERN
Middle Name:RAYMOND
Last Name:VERLING
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:139 W RICHMOND AVE STE B
Mailing Address - Street 2:
Mailing Address - City:POINT RICHMOND
Mailing Address - State:CA
Mailing Address - Zip Code:94801-3935
Mailing Address - Country:US
Mailing Address - Phone:510-232-7897
Mailing Address - Fax:866-247-6762
Practice Address - Street 1:139 W RICHMOND AVE STE B
Practice Address - Street 2:
Practice Address - City:POINT RICHMOND
Practice Address - State:CA
Practice Address - Zip Code:94801-3935
Practice Address - Country:US
Practice Address - Phone:510-232-7897
Practice Address - Fax:866-247-6762
Is Sole Proprietor?:Yes
Enumeration Date:2012-01-23
Last Update Date:2012-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA35360183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA35360OtherCALIFORNIA LICENSE NUMBER