Active NPI
Haley Bradford, PHARMD
- Pharmacist
- Vivian, LA
National Provider Identifier
1356864359
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- PST.022051
- Practice address
- 929 S Pine St
Vivian, LA 71082-3364 - Phone
- (318) 375-4510
- NPI assigned
- Jul 21, 2017
- Last updated
- Jun 13, 2022
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | PST.022051 | LA | Primary |
Addresses
Primary practice location
929 S Pine St
Vivian, LA 71082-3364
Mailing address
90 Kingston Xing Apt 702
Bossier City, LA 71111-6283
Phone (870) 831-0003
Other practice location 1
1645 E Bert Kouns Industrial Loop
Shreveport, LA 71105-5725
Phone (318) 797-9165
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
| License | State | Type | Specialty |
|---|---|---|---|
| PST.022051 | LA | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Wal-Mart Stores East LP | Past | Accepting new patients | |
| Wal-Mart Stores East, LP | Past | Accepting new patients |
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
dba Wal-Mart Pharmacy 10-116
- Community/Retail Pharmacy
- Vivian, LA
- NPI 1154348415
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1500595200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1655078400000",
"number": "1356864359",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "90 KINGSTON XING APT 702",
"city": "BOSSIER CITY",
"state": "LA",
"postal_code": "711116283",
"telephone_number": "870-831-0003"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "929 S PINE ST",
"city": "VIVIAN",
"state": "LA",
"postal_code": "710823364",
"telephone_number": "318-375-4510"
}
],
"practiceLocations": [
{
"address_1": "1645 E Bert Kouns Industrial Loop",
"address_purpose": "LOCATION",
"city": "Shreveport",
"state": "LA",
"postal_code": "711055725",
"country_code": "US",
"telephone_number": "318-797-9165",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "BRADFORD",
"first_name": "HALEY",
"credential": "PHARMD",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2017-07-21",
"last_updated": "2022-06-13",
"certification_date": "2022-06-13",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "LA",
"license": "PST.022051",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Vivian, LA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 13, 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.