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General NPI Number Information
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NPI Number | 1407945058
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Entity Type | Organization
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Legal Business Name | BRADFORD DRUGSTORE, INC.
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Dates
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Enumeration Date | 10/12/2006
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Last Update Date | 01/15/2025
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Provider Practice Location Address
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Address Line | 500 N MAIN ST
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City | CEDARTOWN
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State | GA
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Zip | 30125-2302
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Country | US
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Telephone | 770-748-3100
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Fax | 770-748-0379
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Provider Business Mailing Address
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Address Line | PO BOX 126
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City | CEDARTOWN
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State | GA
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Zip | 30125-0126
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Country | US
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Telephone | 770-748-3100
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Fax | 770-748-0379
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Authorized Official
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Title or Position | OWNER
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Name | DR. PETER JUSTIN STRICKLAND
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Credential | PHARMD, MBA
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Telephone | 770-748-3100
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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 |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number |
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License Number State |
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