Provider Demographics
NPI:1710601968
Name:BERRY, JOSHUA CHRISTOPHER (PHARMD)
Entity Type:Individual
Prefix:
First Name:JOSHUA
Middle Name:CHRISTOPHER
Last Name:BERRY
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 1:1511 CHRISTY DR
Mailing Address - Street 2:
Mailing Address - City:JEFFERSON CITY
Mailing Address - State:MO
Mailing Address - Zip Code:65101-2854
Mailing Address - Country:US
Mailing Address - Phone:314-560-8583
Mailing Address - Fax:
Practice Address - Street 1:1511 CHRISTY DR
Practice Address - Street 2:
Practice Address - City:JEFFERSON CITY
Practice Address - State:MO
Practice Address - Zip Code:65101-2854
Practice Address - Country:US
Practice Address - Phone:314-560-8583
Practice Address - Fax:573-632-2769
Is Sole Proprietor?:No
Enumeration Date:2022-09-30
Last Update Date:2023-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2022031294183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist