Provider Demographics
NPI:1851789853
Name:TREST, CASEY (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:CASEY
Middle Name:
Last Name:TREST
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:825 E BURGESS RD
Mailing Address - Street 2:
Mailing Address - City:PENSACOLA
Mailing Address - State:FL
Mailing Address - Zip Code:32504-7001
Mailing Address - Country:US
Mailing Address - Phone:850-473-9190
Mailing Address - Fax:850-473-9935
Practice Address - Street 1:825 E BURGESS RD
Practice Address - Street 2:
Practice Address - City:PENSACOLA
Practice Address - State:FL
Practice Address - Zip Code:32504-7001
Practice Address - Country:US
Practice Address - Phone:850-473-9190
Practice Address - Fax:850-473-9935
Is Sole Proprietor?:No
Enumeration Date:2014-12-30
Last Update Date:2014-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS48537183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist