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General NPI Number Information
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NPI Number | 1407769474
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Entity Type | Individual
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Provider Name | TYLER BRADY PHARMACIST
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Gender | Male
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Dates
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Enumeration Date | 09/23/2026
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Last Update Date | 09/23/2026
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Provider Practice Location Address
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Address Line | 519 MONUMENT ST
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City | GREENWOOD
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State | SC
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Zip | 29646-2622
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Country | US
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Telephone | 864-407-4160
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Fax | 864-407-4155
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Provider Business Mailing Address
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Address Line | 4600 MONTGOMERY RD STE 400
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City | CINCINNATI
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State | OH
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Zip | 45212-2600
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 38085
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License Number State | SC
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