Michael F. Bertagnolli, RPH
Individual provider Active NPI Pharmacist · Bozeman, MT
NPI 1841401320 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1841401320
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pharmacist 183500000X
- License
- 3356 PHA (MT)
- Practice address
- 915 Highland Blvd
Bozeman, MT 59715-6902 - Phone
- (406) 522-1759
- NPI assigned
- May 25, 2007
- Sex
- Male
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- Credentials
- Registered Pharmacist
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 3356 PHA | MT | MD | Pharmacist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 3356 PHA | MT | Yes |
Addresses
Primary practice location
915 Highland Blvd
Bozeman, MT 59715-6902
Mailing address
915 Highland Blvd
Bozeman, MT 59715-6902
Phone (406) 522-1759
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 3356PHA | Other | MT | LICENSE NUMBER |
Other providers in Bozeman, MT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.