Healthcare Provider Details
I. General information
NPI: 1104833045
Provider Name (Legal Business Name): BRADEN PARTNERS LP
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 08/02/2006
Last Update Date: 08/26/2013
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
41758 12TH ST W SUITE E
PALMDALE CA
93551-1421
US
IV. Provider business mailing address
8730 HARRIS RD UNIT 204
BAKERSFIELD CA
93311-8990
US
V. Phone/Fax
- Phone: 661-945-2122
- Fax: 661-945-0151
- Phone: 661-396-3720
- Fax: 661-832-6009
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 332BX2000X |
| Taxonomy | Oxygen Equipment & Supplies (DME) |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
JANE
L
THOMAS
Title or Position: CHIEF EXECUTIVE OFFICER
Credential:
Phone: 415-893-1518