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General NPI Number Information
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NPI Number | 1548512361
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Entity Type | Organization
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Legal Business Name | BRADLEY PHARMACY AT METRO CENTER
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Dates
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Enumeration Date | 10/03/2012
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Last Update Date | 10/03/2012
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Provider Practice Location Address
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Address Line | 131 FRENCH LANDING DR
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City | NASHVILLE
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State | TN
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Zip | 37228-1511
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Country | US
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Telephone | 615-687-4938
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Fax |
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Provider Business Mailing Address
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Address Line | 131 FRENCH LANDING DR
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City | NASHVILLE
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State | TN
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Zip | 37228-1511
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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 | PRESIDENT
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Name | DR. PHILLIP WILSON BRADLEY
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Credential | D.PH.
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Telephone | 615-383-2741
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number | 5091
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License Number State | TN
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