Provider Demographics
NPI:1922563311
Name:BERRIE, GINGER SCHWORM (RPH)
Entity Type:Individual
Prefix:
First Name:GINGER
Middle Name:SCHWORM
Last Name:BERRIE
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4590 SUNNY CREEK LN
Mailing Address - Street 2:
Mailing Address - City:SYLVANIA
Mailing Address - State:OH
Mailing Address - Zip Code:43560-7202
Mailing Address - Country:US
Mailing Address - Phone:419-351-5600
Mailing Address - Fax:
Practice Address - Street 1:4590 SUNNY CREEK LN
Practice Address - Street 2:
Practice Address - City:SYLVANIA
Practice Address - State:OH
Practice Address - Zip Code:43560-7202
Practice Address - Country:US
Practice Address - Phone:419-351-5600
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-02-10
Last Update Date:2019-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH03223389183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist