Provider Demographics
NPI:1558641183
Name:BERTRAND, JAMES B (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:B
Last Name:BERTRAND
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:DR
Other - First Name:CHRISTOPHER
Other - Middle Name:JAMES
Other - Last Name:BOTTOM
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PHARMD
Mailing Address - Street 1:11930 STANDIFORD PLAZA DR
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40229-5901
Mailing Address - Country:US
Mailing Address - Phone:502-961-5843
Mailing Address - Fax:
Practice Address - Street 1:11930 STANDIFORD PLAZA DR
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40229-5901
Practice Address - Country:US
Practice Address - Phone:502-961-5843
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-08-26
Last Update Date:2011-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY012828183500000X
IN26021587A183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist