Individual provider Active NPI

Bradley Glenn Harvala, PHARMD.

  • Pharmacist
  • Marquette, MI
National Provider Identifier
1295016558
Registry record updated Aug 31, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
5302033897 Issued in MI
Practice address
425 Fisher St
Marquette, MI 49855-4521
Phone
(906) 226-3576
NPI assigned
Aug 31, 2011
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 31, 2011

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 5302033897 MI Primary

Addresses

Primary practice location

425 Fisher St
Marquette, MI 49855-4521

Mailing address

425 Fisher St
Marquette, MI 49855-4521
Phone (906) 226-3576

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Doctor of Pharmacy

State licenses

LicenseStateTypeSpecialty
5302033897MIMDPharmacist

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1314748800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1314748800000",
    "number": "1295016558",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "425 FISHER ST",
            "city": "MARQUETTE",
            "state": "MI",
            "postal_code": "498554521",
            "telephone_number": "906-226-3576"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "425 FISHER ST",
            "city": "MARQUETTE",
            "state": "MI",
            "postal_code": "498554521",
            "telephone_number": "906-226-3576"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HARVALA",
        "first_name": "BRADLEY",
        "middle_name": "GLENN",
        "name_prefix": "Mr.",
        "credential": "PHARMD.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-08-31",
        "last_updated": "2011-08-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "MI",
            "license": "5302033897",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Marquette, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 31, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.