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General NPI Number Information
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NPI Number | 1720260664
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Entity Type | Individual
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Provider Name | BRADLEY BIRD PHARMD
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Gender | Male
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Dates
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Enumeration Date | 12/03/2007
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Last Update Date | 12/03/2007
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Provider Practice Location Address
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Address Line | 1570 CLEVELAND AVE
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City | COLUMBUS
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State | OH
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Zip | 43211-2755
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Country | US
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Telephone | 614-299-2039
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Fax | 614-299-0965
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Provider Business Mailing Address
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Address Line | 2575 W BROAD ST
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City | COLUMBUS
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State | OH
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Zip | 43204-3333
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Country | US
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Telephone | 614-278-9666
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Fax | 614-278-2385
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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 | 03-2-28186
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License Number State | OH
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