Kristen Bradesku, PHARMD

Primary specialty

PharmacistTaxonomy code 183500000X

License

03337681 Issued in OH

Practice address

26611 Dixie Hwy Ste 119
Perrysburg, OH 43551-1749

Phone

(419) 873-2800

Fax

(419) 873-0494

NPI assigned

Aug 24, 2022

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Pharmacy

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Buderer Drug Co.

  • Specialty Pharmacy
  • Perrysburg, OH
  • NPI 1174673362
  NPD (past)

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

{
    "created_epoch": "1661299200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1661299200000",
    "number": "1336868264",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "26611 DIXIE HWY STE 119",
            "city": "PERRYSBURG",
            "state": "OH",
            "postal_code": "435511749",
            "telephone_number": "419-873-2800",
            "fax_number": "419-873-0494"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "26611 DIXIE HWY STE 119",
            "city": "PERRYSBURG",
            "state": "OH",
            "postal_code": "435511749",
            "telephone_number": "419-873-2800",
            "fax_number": "419-873-0494"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRADESKU",
        "first_name": "KRISTEN",
        "credential": "PHARMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-08-24",
        "last_updated": "2022-08-24",
        "certification_date": "2022-07-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "OH",
            "license": "03337681",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Stephanie A Born, PH.D., RD, LD
• Elena Maria Clara Bortoleto
• Ronald Boudouris, LISW
• Lacey Bova
• Theodore Henry Bowlus, DPM
• Christina Brancheau, M.S., CCC/SLP
• Valerie Sue Brandal, PSYD, LMSW, LISW-S
• Andrew Phillip Brandeberry
• Ariel Brandt
• Elizabeth Brashear, LISW-S

• All providers in Perrysburg, OH
• Pharmacist in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 24, 2022; 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.