MEDICARE: BRADLEY'S HOME HEALTH CARE CENTER

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
1	3336H0001X	Home Infusion Therapy Pharmacy	4437477	TN

General Provider Information

NPI Number	:	1629364864
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BRADLEY'S HOME HEALTH CARE CENTER

Provider Business Mailing Address
First Line	:	5208 CHARLOTTE PIKE
Second Line	:
City	:	NASHVILLE
State	:	TN
Zip	:	37209-3321
Country	:	US
Telephone Number	:	615-383-9516
Fax Number	:	615-279-1347

Provider Business Practice Location Address
First Line	:	5208 CHARLOTTE AVENUE
Second Line	:
City	:	NASHVILLE
State	:	TN
Zip	:	37209-3321
Country	:	US
Telephone Number	:	615-383-9516
Fax Number	:	615-279-1347

Authorized Official
Title or Position	:	CEO
Name	:	MR. PHILLIP W. BRADLEY
Credential	:
Telephone Number	:	615-383-9516

Provider Enumeration Date	:	06/27/2011
Last Update Date	:	07/06/2011

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