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NPI Code Detail

MEDICARE: BRADLEY BIRD PHARMD

MEDICARE:   BRADLEY  BIRD  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
1183500000XPharmacist03-2-28186OH

General Provider Information

NPI Number : 1720260664
Entity Type Code : Individual
Provider Name (Legal Business Name) : BRADLEY BIRD PHARMD
Provider Business Mailing Address
First Line : 2575 W BROAD ST
Second Line :
City : COLUMBUS
State : OH
Zip : 43204-3333
Country : US
Telephone Number : 614-278-9666
Fax Number : 614-278-2385
Provider Business Practice Location Address
First Line : 1570 CLEVELAND AVE
Second Line :
City : COLUMBUS
State : OH
Zip : 43211-2755
Country : US
Telephone Number : 614-299-2039
Fax Number : 614-299-0965
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/03/2007
Last Update Date : 12/03/2007

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Directions to “ BRADLEY BIRD PHARMD” Practice Location

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