Basic Information
| Provider Information | |||||||||
| NPI: | 1386644003 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | BERRY | ||||||||
| FirstName: | JONI | ||||||||
| MiddleName: | INGRAM | ||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | PHARMD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 8804 HIGHHILL RD | ||||||||
| Address2: | |||||||||
| City: | RALEIGH | ||||||||
| State: | NC | ||||||||
| PostalCode: | 276152030 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9198477501 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 1300 ST. MARY'S ST | ||||||||
| Address2: | FOURTH FLOOR | ||||||||
| City: | RALEIGH | ||||||||
| State: | NC | ||||||||
| PostalCode: | 276051276 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9198280890 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/22/2005 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 1835P1200X | 06654 | NC | Y | Pharmacy Service Providers | Pharmacist | Pharmacotherapy |
No ID Information.