Healthcare Provider Details

I. General information

NPI: 1225211618
Provider Name (Legal Business Name): MR. OLEG BERSHAD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/10/2007
Last Update Date: 06/16/2026
Certification Date: 06/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3261 E PECOS RD
GILBERT AZ
85295-1200
US

IV. Provider business mailing address

3261 E PECOS RD
GILBERT AZ
85295-1200
US

V. Phone/Fax

Practice location:
  • Phone: 480-988-6300
  • Fax:
Mailing address:
  • Phone: 480-988-6300
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835P0018X
TaxonomyPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
License NumberS023445
License Number StateAZ
# 2
Primary TaxonomyN
Taxonomy Code183500000X
TaxonomyPharmacist
License Number047360
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: