Provider Demographics
NPI:1992329569
Name:BERARDI ENTERPRISES
Entity type:Organization
Organization Name:BERARDI ENTERPRISES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:PHILIP
Authorized Official - Middle Name:J
Authorized Official - Last Name:BERARDI
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:901-323-3613
Mailing Address - Street 1:3675 SUMMER AVE
Mailing Address - Street 2:
Mailing Address - City:MEMPHIS
Mailing Address - State:TN
Mailing Address - Zip Code:38122-3742
Mailing Address - Country:US
Mailing Address - Phone:901-323-3613
Mailing Address - Fax:901-454-5939
Practice Address - Street 1:6450 POPLAR AVE STE 113
Practice Address - Street 2:
Practice Address - City:MEMPHIS
Practice Address - State:TN
Practice Address - Zip Code:38119-4882
Practice Address - Country:US
Practice Address - Phone:731-445-7278
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-05-30
Last Update Date:2020-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty