Edward Glenn Bernatowicz, RPH

Primary specialty

Pharmacist Clinician (PhC)/ Clinical Pharmacy SpecialistTaxonomy code 1835P0018X

License

PST.010749 Issued in LA

Practice address

2600 Greenwood Rd
Shreveport, LA 71103-3908

Phone

(318) 212-4170

NPI assigned

Oct 13, 2016

Last updated

Oct 13, 2016By the provider in NPPES

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Registered Pharmacist

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1476316800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1476316800000",
    "number": "1427508456",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "317 WILD OAK DR",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "711068227"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2600 GREENWOOD RD",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "711033908",
            "telephone_number": "318-212-4170"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BERNATOWICZ",
        "first_name": "EDWARD",
        "middle_name": "GLENN",
        "credential": "RPH",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-10-13",
        "last_updated": "2016-10-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1835P0018X",
            "taxonomy_group": "",
            "desc": "Pharmacist, Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist",
            "state": "LA",
            "license": "PST.010749",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LOUISIANA STATE PHARMACIST LICENSE NUMBER",
            "identifier": "PST.010749",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Emily Bergeron, PA-C
• Natalie Berlin, LPC
• Amanda Bernard
• Brennan Anthony Bernard
• Thomas Jeffrey Bernard, M.D.
• Brian E. Bernhardt, M.D.
• Wendy K Bernstein, M.D.
• Malcolm Bernstine, PH.D
• Austin Gordon Berry, DO
• Christopher S Berry, MSPT

• Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist in Shreveport, LA
• Providers in Shreveport, LA by specialty
• Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 13, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.