Charles Bertagnolli Jr., PHARM.D.
Individual provider Active NPI Pharmacist · Roeland Park, KS
NPI 1922593698 · NPPES record last updated Jun 26, 2018
Key facts
- NPI
- 1922593698
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pharmacist 183500000X
- License
- 2018021529 (MO)
- Practice address
- 4976 Skyline Dr
Roeland Park, KS 66205-1148 - Phone
- (573) 821-6418
- NPI assigned
- Jun 26, 2018
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- Credentials
- Doctor of Pharmacy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2018021529 | MO | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Bertagnolli Medciation Services | Current | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 2018021529 | MO | Yes |
Addresses
Primary practice location
4976 Skyline Dr
Roeland Park, KS 66205-1148
Mailing address
4976 Skyline Dr
Roeland Park, KS 66205-1148
Phone (573) 821-6418
Other providers in Roeland Park, KS
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 26, 2018. 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.