Provider Demographics
NPI:1851686687
Name:BERRY, FRANK JAMES (RPH)
Entity Type:Individual
Prefix:MR
First Name:FRANK
Middle Name:JAMES
Last Name:BERRY
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 1:2432 E SAPIUM WAY
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85048-9198
Mailing Address - Country:US
Mailing Address - Phone:480-231-8486
Mailing Address - Fax:
Practice Address - Street 1:2432 E SAPIUM WAY
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85048-9198
Practice Address - Country:US
Practice Address - Phone:480-231-8486
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-06-09
Last Update Date:2011-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZS012825183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist