Healthcare Provider Details

I. General information

NPI: 1336181296
Provider Name (Legal Business Name): BRADEN MED SVS INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/12/2006
Last Update Date: 04/17/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

44523 MARIETTA RD
CALDWELL OH
43724-9209
US

IV. Provider business mailing address

44523 MARIETTA RD
CALDWELL OH
43724-9209
US

V. Phone/Fax

Practice location:
  • Phone: 740-732-2356
  • Fax: 740-732-2377
Mailing address:
  • Phone: 740-732-2356
  • Fax: 740-732-2377

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code333600000X
TaxonomyPharmacy
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number021296950
License Number StateOH

VIII. Authorized Official

Name: KYLE HUCK
Title or Position: DIRECTOR OF OPERATIONS
Credential:
Phone: 740-732-2356