Provider Demographics
NPI:1316428667
Name:BERTSCH, TREVOR ALAN (PHARMD, MBA)
Entity type:Individual
Prefix:DR
First Name:TREVOR
Middle Name:ALAN
Last Name:BERTSCH
Suffix:
Gender:M
Credentials:PHARMD, MBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1250 CENTRAL AVE SE
Mailing Address - Street 2:
Mailing Address - City:LE MARS
Mailing Address - State:IA
Mailing Address - Zip Code:51031-2721
Mailing Address - Country:US
Mailing Address - Phone:402-644-1578
Mailing Address - Fax:
Practice Address - Street 1:714 LINCOLN ST NE
Practice Address - Street 2:
Practice Address - City:LE MARS
Practice Address - State:IA
Practice Address - Zip Code:51031-3311
Practice Address - Country:US
Practice Address - Phone:712-546-3738
Practice Address - Fax:712-546-3747
Is Sole Proprietor?:No
Enumeration Date:2018-08-24
Last Update Date:2024-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE14248183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist