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NPI Code Detail

MEDICARE: JOHN BRADLEY PHARMD

MEDICARE: JOHN BRADLEY PHARMD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1183500000XPharmacistPD14061AR

General Provider Information

NPI Number : 1487391942
Entity Type Code : Individual
Provider Name (Legal Business Name) : JOHN BRADLEY PHARMD
Provider Business Mailing Address
First Line : 11 CLERVAUX DR
Second Line :
City : LITTLE ROCK
State : AR
Zip : 72223-5510
Country : US
Telephone Number : 870-784-2540
Fax Number :
Provider Business Practice Location Address
First Line : 2609 MCCAIN BLVD
Second Line :
City : NORTH LITTLE ROCK
State : AR
Zip : 72116-8013
Country : US
Telephone Number : 501-353-1984
Fax Number : 501-353-2698
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/17/2022
Last Update Date : 05/17/2022

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Directions to “ JOHN BRADLEY PHARMD” Practice Location

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