Provider Demographics
NPI:1972027126
Name:BERGRIN, KERRI ERIN (PHARMD)
Entity Type:Individual
Prefix:
First Name:KERRI
Middle Name:ERIN
Last Name:BERGRIN
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 1:3608 W FOREST LAKE DR
Mailing Address - Street 2:
Mailing Address - City:FLORENCE
Mailing Address - State:SC
Mailing Address - Zip Code:29501-8271
Mailing Address - Country:US
Mailing Address - Phone:843-468-1728
Mailing Address - Fax:
Practice Address - Street 1:1295 E MAIN ST
Practice Address - Street 2:
Practice Address - City:ROCK HILL
Practice Address - State:SC
Practice Address - Zip Code:29730-5947
Practice Address - Country:US
Practice Address - Phone:803-324-7563
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-07-31
Last Update Date:2017-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC37279183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist