Provider Demographics
NPI:1053146233
Name:BERTSCH, JOSHUA PAUL (PHARMD)
Entity type:Individual
Prefix:MR
First Name:JOSHUA
Middle Name:PAUL
Last Name:BERTSCH
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:965 COUNTY HIGHWAY 16
Mailing Address - Street 2:
Mailing Address - City:SYCAMORE
Mailing Address - State:OH
Mailing Address - Zip Code:44882-9417
Mailing Address - Country:US
Mailing Address - Phone:567-230-0300
Mailing Address - Fax:
Practice Address - Street 1:1049 W 4TH ST
Practice Address - Street 2:
Practice Address - City:MANSFIELD
Practice Address - State:OH
Practice Address - Zip Code:44906-1945
Practice Address - Country:US
Practice Address - Phone:419-529-6001
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-09-05
Last Update Date:2024-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH03444770183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist