Leanne Bertha, PHARMD
Individual provider Active NPI Pharmacist · Coventry, RI
NPI 1962003467 · NPPES record last updated Nov 3, 2020
Key facts
- NPI
- 1962003467
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pharmacist 183500000X
- License
- RPH05144 (RI)
- Practice address
- 650 Centre of New England Blvd
Coventry, RI 02816-6081 - Phone
- (401) 823-7060
- NPI assigned
- Nov 3, 2020
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 2
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 |
|---|---|---|---|
| PCT.0012321 | CT | MD | Pharmacist |
| RPH05144 | RI | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Wal-Mart Stores East LP | Past |
Accepting new patients | |
| Wal-Mart Stores East, LP | Past |
Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | PCT.0012321 | CT | |
| Pharmacist | 183500000X | RPH05144 | RI | Yes |
Addresses
Primary practice location
650 Centre of New England Blvd
Coventry, RI 02816-6081
Mailing address
650 Centre of New England Blvd
Coventry, RI 02816-6081
Phone (401) 823-7060
Other providers in Coventry, RI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 3, 2020. 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.