Michael Brian Brady, PHARMD

Individual provider Active NPI Pharmacist · Pine Ridge, SD

NPI 1316246259 · NPPES record last updated Mar 17, 2011

Key facts

NPI
1316246259
Entity type
Individual (NPI type 1)
Primary specialty
Pharmacist 183500000X
License
1-1505 (KS)
Practice address
East Hiway 18
Pine Ridge, SD 57770-1201
Phone
(605) 867-3192
NPI assigned
Mar 17, 2011
Sex
Male
Sole proprietor
No

Medicare participation

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

National Provider Directory

Medicare enrollment (NPD)
No
Credentials
Doctor of Pharmacy

State licenses

LicenseStateTypeSpecialty
18932COMDPharmacist
1-1505KSMDPharmacist

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 18932 CO
Pharmacist 183500000X 1-1505 KS Yes

Addresses

Primary practice location

East Hiway 18
Pine Ridge, SD 57770-1201

Mailing address

PO Box 1201
Pine Ridge, SD 57770-1201
Phone (605) 867-3192

Other providers in Pine Ridge, SD

All providers in Pine Ridge, SD · Pharmacist in South Dakota

Sources for this page

Verify at the official NPI Registry.