MEDICARE: BRAD ENTERPRISES, INC.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251E00000X	Home Health Agency

General Provider Information

NPI Number	:	1104034719
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BRAD ENTERPRISES, INC.

Provider Business Mailing Address
First Line	:	64 MARCO LN
Second Line	:
City	:	DAYTON
State	:	OH
Zip	:	45458-3817
Country	:	US
Telephone Number	:	937-312-9900
Fax Number	:	937-312-9111

Provider Business Practice Location Address
First Line	:	64 MARCO LN
Second Line	:
City	:	DAYTON
State	:	OH
Zip	:	45458-3817
Country	:	US
Telephone Number	:	937-312-9900
Fax Number	:	937-312-9111

Authorized Official
Title or Position	:	OWNER
Name	:	MRS. CAROL L. BRAD
Credential	:	RN
Telephone Number	:	937-312-9900

Provider Enumeration Date	:	05/18/2007
Last Update Date	:	09/05/2008

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Directions to “BRAD ENTERPRISES, INC. ” Practice Location

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