Provider Demographics
NPI:1841626785
Name:B7 PHARMACY INC
Entity type:Organization
Organization Name:B7 PHARMACY INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PHARMACIST
Authorized Official - Prefix:
Authorized Official - First Name:ALEX
Authorized Official - Middle Name:C
Authorized Official - Last Name:BERCE
Authorized Official - Suffix:
Authorized Official - Credentials:RPH, PHARMD
Authorized Official - Phone:262-658-8124
Mailing Address - Street 1:3825 39TH AVE STE 100
Mailing Address - Street 2:
Mailing Address - City:KENOSHA
Mailing Address - State:WI
Mailing Address - Zip Code:53144
Mailing Address - Country:US
Mailing Address - Phone:262-658-8124
Mailing Address - Fax:262-564-8667
Practice Address - Street 1:3825 39TH AVE STE 100
Practice Address - Street 2:
Practice Address - City:KENOSHA
Practice Address - State:WI
Practice Address - Zip Code:53144
Practice Address - Country:US
Practice Address - Phone:262-658-8124
Practice Address - Fax:262-564-8667
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-09-24
Last Update Date:2017-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI9225-423336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI3954760004Medicare NSC