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Mary Bergstrom, PHARM D

NPI 1285234211ActiveIndividual· Pharmacist· Fort Wayne, IN

Pharmacist (PHARM D) in Fort Wayne, Indiana, licensed in IN and MI, with an NPI issued in October 2020.

Overview

NPI1285234211
StatusActive
Entity typeIndividual
CredentialPHARM D
Sole proprietorYes
NPI issuedOct 28, 2020
Last updated in NPPESOct 28, 2020
Certified by providerOct 28, 2020

Specialties and licenses

TaxonomyCodeLicenseState
Pharmacist Primary183500000X26020791AIN
Pharmacist183500000X5302030388MI

About license numbers in NPPES

Exclusion screening

ListResultDetails
HHS-OIG LEIE · Nov 10, 2026No matchChecked by NPI and by name + state
North Carolina Medicaid · Nov 11, 2026No match—
New York OMIG · Nov 11, 2026No match—
Ohio Medicaid · Nov 11, 2026No match—
Pennsylvania Medicheck · Nov 11, 2026No match—
Washington HCA · Nov 11, 2026No match—

Official OIG search · How matching works ·Bulk check a roster

Medicare

Enrollment (PECOS)Not in the public enrollment file of Oct 1, 2026

Medicare sources and data years

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