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NPI Code Detail

MEDICARE: BRAD LEE BEDWELL

MEDICARE: BRAD LEE BEDWELL
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
1183500000XPharmacist18198IA

General Provider Information

NPI Number : 1912526542
Entity Type Code : Individual
Provider Name (Legal Business Name) : BRAD LEE BEDWELL
Provider Business Mailing Address
First Line : 4605 FLEUR DR
Second Line :
City : DES MOINES
State : IA
Zip : 50321-2333
Country : US
Telephone Number : 515-285-7133
Fax Number :
Provider Business Practice Location Address
First Line : 4605 FLEUR DR
Second Line :
City : DES MOINES
State : IA
Zip : 50321-2333
Country : US
Telephone Number : 515-285-7133
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/14/2020
Last Update Date : 04/14/2020

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Directions to “ BRAD LEE BEDWELL ” Practice Location

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