Healthcare Provider Details

I. General information

NPI: 1366356206
Provider Name (Legal Business Name): BRADLY A HUGUNIN PHARM D
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/29/2026
Last Update Date: 09/29/2026
Certification Date: 09/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7620 STATE LINE RD
PRAIRIE VILLAGE KS
66208-3705
US

IV. Provider business mailing address

8802 W 90TH TER
OVERLAND PARK KS
66212-3850
US

V. Phone/Fax

Practice location:
  • Phone: 913-383-8322
  • Fax: 913-383-8362
Mailing address:
  • Phone: 913-515-4066
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number1-103663
License Number StateKS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: