Bertram Pride, is a
Licensed Practical Nurse based in Park City, Utah. Bertram Pride is licensed to practice in Michigan (license number 4703111838) and his current practice location is
1640 Redstone Center Dr, Park City, Utah. He can be reached at his office (for appointments etc.) via phone at
(214) 264-9711.
NPI number for Bertram Pride is 1518593110 and his current mailing address is 8931 Pardee Rd, Taylor, Michigan. He
does not participate in medicare program and thus does not accept medicare assignments. His NPI Number is 1518593110.
Provider's Profile
| Full Name | Bertram Pride |
|---|
| Gender | Male |
|---|
| Speciality | Licensed Practical Nurse |
|---|
| Location | 1640 Redstone Center Dr, Park City, Utah |
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| Accepts Medicare Assignments | Does not participate in Medicare Program. He may not accept medicare assignment. |
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NPI Data:
- NPI Number: 1518593110
- Provider Enumeration Date: 03/16/2020
- Last Update Date: 03/16/2020
Medical Identifiers
Medical identifiers for Bertram Pride such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1518593110 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 164W00000X | Licensed Practical Nurse | 4703111838 (Michigan) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Bertram Pride is
NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
|---|
Bertram Pride,
8931 Pardee Rd,
Taylor, MI 48180-2741
Ph: () - | Bertram Pride,
1640 Redstone Center Dr,
Park City, UT 84098-7605
Ph: (214) 264-9711 |
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