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NPI Code Detail

MEDICARE: DR. ELIZABETH BRADLEY PHARM.D.

MEDICARE: DR. ELIZABETH BRADLEY PHARM.D.
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
1183500000XPharmacistRP446689PA
2183500000XPharmacistRPI006830PA

General Provider Information

NPI Number : 1497117220
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. ELIZABETH BRADLEY PHARM.D.
Provider Business Mailing Address
First Line : 2946 ISLAND AVE
Second Line : SHOPRITE PHARMACY
City : PHILADELPHIA
State : PA
Zip : 19153-2026
Country : US
Telephone Number : 215-937-0327
Fax Number : 215-492-1835
Provider Business Practice Location Address
First Line : 2946 ISLAND AVE
Second Line : SHOPRITE PHARMACY
City : PHILADELPHIA
State : PA
Zip : 19153-2026
Country : US
Telephone Number : 215-937-0327
Fax Number : 215-492-1835
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/22/2016
Last Update Date : 03/22/2016

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