Provider Demographics
NPI:1811735699
Name:BERRYMAN, ALLISON ANN-ELIZABETH (PHARMD, RPH)
Entity type:Individual
Prefix:
First Name:ALLISON
Middle Name:ANN-ELIZABETH
Last Name:BERRYMAN
Suffix:
Gender:F
Credentials:PHARMD, RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18270 WETZEL RD
Mailing Address - Street 2:
Mailing Address - City:MIDDLE POINT
Mailing Address - State:OH
Mailing Address - Zip Code:45863-9559
Mailing Address - Country:US
Mailing Address - Phone:419-203-2255
Mailing Address - Fax:
Practice Address - Street 1:11109 PARKVIEW PLAZA DR
Practice Address - Street 2:
Practice Address - City:FORT WAYNE
Practice Address - State:IN
Practice Address - Zip Code:46845-1701
Practice Address - Country:US
Practice Address - Phone:260-266-4400
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-07-17
Last Update Date:2024-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH03443752183500000X
IN26030382A183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist