MEDICARE: MR. BRAD J. CUMMINGS RPH

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	183500000X	Pharmacist	8133	OR

General Provider Information

NPI Number	:	1861603292
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. BRAD J. CUMMINGS RPH

Provider Business Mailing Address
First Line	:	6715 EBERLEIN AVE
Second Line	:
City	:	KLAMATH FALLS
State	:	OR
Zip	:	97603-5252
Country	:	US
Telephone Number	:	541-883-2947
Fax Number	:	541-883-6104

Provider Business Practice Location Address
First Line	:	2909 DAGGETT AVE
Second Line	:	SUITE 200
City	:	KLAMATH FALLS
State	:	OR
Zip	:	97601
Country	:	US
Telephone Number	:	541-883-2947
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/25/2007
Last Update Date	:	07/08/2007

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