Provider Demographics
NPI:1265787741
Name:BERTI, CHERI (RPH)
Entity type:Individual
Prefix:MS
First Name:CHERI
Middle Name:
Last Name:BERTI
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1605 MARTIN SPRINGS DR
Mailing Address - Street 2:SUITE 220
Mailing Address - City:ROLLA
Mailing Address - State:MO
Mailing Address - Zip Code:65401-2931
Mailing Address - Country:US
Mailing Address - Phone:573-458-6433
Mailing Address - Fax:573-458-6441
Practice Address - Street 1:1605 MARTIN SPRINGS DR
Practice Address - Street 2:SUITE 220
Practice Address - City:ROLLA
Practice Address - State:MO
Practice Address - Zip Code:65401-2931
Practice Address - Country:US
Practice Address - Phone:573-458-6433
Practice Address - Fax:573-458-6441
Is Sole Proprietor?:No
Enumeration Date:2012-07-19
Last Update Date:2012-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO042641183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist