Provider Demographics
NPI:1275276180
Name:BERTRAM SARDINIA PHARMACY
Entity Type:Organization
Organization Name:BERTRAM SARDINIA PHARMACY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ALEXANDER
Authorized Official - Middle Name:
Authorized Official - Last Name:BERTRAM
Authorized Official - Suffix:
Authorized Official - Credentials:PHARMD, MS
Authorized Official - Phone:937-446-2545
Mailing Address - Street 1:7110 BACHMAN RD UNIT 2
Mailing Address - Street 2:
Mailing Address - City:SARDINIA
Mailing Address - State:OH
Mailing Address - Zip Code:45171-9467
Mailing Address - Country:US
Mailing Address - Phone:937-446-2545
Mailing Address - Fax:937-446-2600
Practice Address - Street 1:7110 BACHMAN RD UNIT 2
Practice Address - Street 2:
Practice Address - City:SARDINIA
Practice Address - State:OH
Practice Address - Zip Code:45171-9467
Practice Address - Country:US
Practice Address - Phone:937-446-2545
Practice Address - Fax:937-446-2600
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-04-18
Last Update Date:2022-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336L0003XSuppliersPharmacyLong Term Care Pharmacy