=====================================================
General NPI Number Information
=====================================================
NPI Number | 1477444909
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | BRADLEY HOME CARE SERVICES AND TRANSPORTATION PLLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 07/12/2025
-----------------------------------------------------
Last Update Date | 07/14/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 3740 EVANS ST STE D
-----------------------------------------------------
City | GREENVILLE
-----------------------------------------------------
State | NC
-----------------------------------------------------
Zip | 27834-5413
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 252-493-2684
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 2611 CONCHO CIR
-----------------------------------------------------
City | GREENVILLE
-----------------------------------------------------
State | NC
-----------------------------------------------------
Zip | 27834-8960
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 252-258-2468
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | ADMINISTRATOR
-----------------------------------------------------
Name | MRS. SHARONDA TRABETH NICHOLSON-BRADLEY
-----------------------------------------------------
Credential | BSN RN
-----------------------------------------------------
Telephone | 252-258-2468
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 343900000X
-----------------------------------------------------
Taxonomy Name | Non-emergency Medical Transport (VAN)
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 253Z00000X
-----------------------------------------------------
Taxonomy Name | In Home Supportive Care Agency
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------