Thomas Richard Bradley, RPH
Individual provider Active NPI Pharmacist · Richland, MI
NPI 1285754382 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1285754382
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pharmacist 183500000X
- License
- 5302025843 (MI)
- Practice address
- 8900 Gull Rd
Richland, MI 49083-9310 - Phone
- (269) 629-9550
- NPI assigned
- Mar 30, 2007
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- Credentials
- Registered Pharmacist
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 5302025843 | MI | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Richland Village Drug Inc | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 5302025843 | MI | Yes |
Addresses
Primary practice location
8900 Gull Rd
Richland, MI 49083-9310
Mailing address
8312 Fernwood St
Augusta, MI 49012-9307
Phone (269) 731-5546
Other providers in Richland, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.