Healthcare Provider Details

I. General information

NPI: 1619943115
Provider Name (Legal Business Name): BRADEN MED SERVICES INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/24/2006
Last Update Date: 04/25/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

44519 MARIETTA RD
CALDWELL OH
43724-9209
US

IV. Provider business mailing address

44519 MARIETTA RD
CALDWELL OH
43724-9209
US

V. Phone/Fax

Practice location:
  • Phone: 740-732-7201
  • Fax: 740-732-2377
Mailing address:
  • Phone: 740-732-7201
  • Fax: 740-732-2377

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code3336H0001X
TaxonomyHome Infusion Therapy Pharmacy
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code333600000X
TaxonomyPharmacy
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code332BX2000X
TaxonomyOxygen Equipment & Supplies (DME)
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code332BP3500X
TaxonomyParenteral & Enteral Nutrition Supplies (DME)
License Number
License Number State
# 6
Primary TaxonomyN
Taxonomy Code332BN1400X
TaxonomyNursing Facility Supplies (DME)
License Number
License Number State
# 7
Primary TaxonomyY
Taxonomy Code3336L0003X
TaxonomyLong Term Care Pharmacy
License Number020637850
License Number StateOH

VIII. Authorized Official

Name: KYLE HUCK
Title or Position: DIRECTOR OF OPERATIONS
Credential: BS BUSINESS
Phone: 740-732-7201