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General NPI Number Information
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NPI Number | 1083701247
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Entity Type | Organization
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Legal Business Name | BRADFORD PHARMACY INC
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Dates
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Enumeration Date | 10/09/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 445 8TH ST
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City | OAKLAND
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State | CA
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Zip | 94607-3901
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Country | US
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Telephone | 510-451-1388
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Fax | 510-451-4810
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Provider Business Mailing Address
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Address Line | 445 8TH ST
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City | OAKLAND
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State | CA
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Zip | 94607-3901
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Country | US
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Telephone | 510-451-1388
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Fax | 510-451-4810
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Authorized Official
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Title or Position | PHARMACIST IN CHARGE
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Name | MR. ALFRED W LAU
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Credential | PHARM D
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Telephone | 510-451-1388
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 333600000X
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Taxonomy Name | Pharmacy
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License Number | PHY37826
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License Number State | CA
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