Provider Demographics
NPI:1689264095
Name:BERKO, JANE AGYEMAN (PHARMD)
Entity Type:Individual
Prefix:
First Name:JANE
Middle Name:AGYEMAN
Last Name:BERKO
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:653 RIVER TRCE
Mailing Address - Street 2:
Mailing Address - City:WESTERVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:43081-1285
Mailing Address - Country:US
Mailing Address - Phone:614-372-9002
Mailing Address - Fax:
Practice Address - Street 1:653 RIVER TRCE
Practice Address - Street 2:
Practice Address - City:WESTERVILLE
Practice Address - State:OH
Practice Address - Zip Code:43081-1285
Practice Address - Country:US
Practice Address - Phone:614-372-9002
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-01-20
Last Update Date:2021-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH031270431835P0018X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1835P0018XPharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy SpecialistGroup - Single Specialty