MEDICARE: BRADEN PARTNERS LP

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	332BX2000X	Oxygen Equipment & Supplies (DME)

General Provider Information

NPI Number	:	1790011674
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BRADEN PARTNERS LP

Provider Business Mailing Address
First Line	:	4300 STINE RD
Second Line	:	STE 800
City	:	BAKERSFIELD
State	:	CA
Zip	:	93313-2354
Country	:	US
Telephone Number	:	661-396-3720
Fax Number	:	661-832-6010

Provider Business Practice Location Address
First Line	:	2825 STOCKYARD RD
Second Line	:	STE G2
City	:	MISSOULA
State	:	MT
Zip	:	59808-1504
Country	:	US
Telephone Number	:	406-728-5454
Fax Number	:	406-541-6189

Authorized Official
Title or Position	:	CFO
Name	:	CHAD H MARTIN
Credential	:
Telephone Number	:	415-893-1518

Provider Enumeration Date	:	10/27/2009
Last Update Date	:	10/27/2009

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