Provider Demographics
NPI:1932708070
Name:VOGTS, BETHANY (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:BETHANY
Middle Name:
Last Name:VOGTS
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1825 29TH ST NE STE E
Mailing Address - Street 2:
Mailing Address - City:CEDAR RAPIDS
Mailing Address - State:IA
Mailing Address - Zip Code:52402-3452
Mailing Address - Country:US
Mailing Address - Phone:319-214-5265
Mailing Address - Fax:319-289-9126
Practice Address - Street 1:1825 29TH ST NE STE E
Practice Address - Street 2:
Practice Address - City:CEDAR RAPIDS
Practice Address - State:IA
Practice Address - Zip Code:52402-3452
Practice Address - Country:US
Practice Address - Phone:319-214-5265
Practice Address - Fax:319-289-9126
Is Sole Proprietor?:No
Enumeration Date:2020-10-20
Last Update Date:2020-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA23919183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist