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Individual

MR. THOMAS RICHARD BERG

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
R.PH.

Contact information

Practice address
39 SHORTCUT ROAD, INCHELIUM, WA 99138-0290
(509) 722-7009
(509) 722-7021
Mailing address
PO BOX 290, INCHELIUM, WA 99138-0290
(509) 722-7009
(509) 722-7021

Taxonomy

Speciality
Code
Description
License number
State
183500000X
Pharmacist
4214
SD
332800000X
Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy
Primary
CF00003827
WA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
4924735
NABP
WA
05
6008767
WA
01
CF00003827
PHARMACY LICENSE
WA
Enumeration date
01/23/2007
Last updated
09/11/2025
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