Brenton Bradford
Individual provider Active NPI Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist · Brazil, IN
NPI 1366225641 · NPPES record last updated Aug 18, 2023
Key facts
- NPI
- 1366225641
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist 1835P0018X
- License
- 26030451A (IN)
- Practice address
- 100 Forest Park PLZ
Brazil, IN 47834-2737 - Phone
- (812) 442-6700
- NPI assigned
- Aug 18, 2023
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 2
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 26030451A | IN | MD | Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Kroger Limited Partnership I | Past |
Accepting new patients | |
| Kroger Limited Partnership I | Past |
Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist | 1835P0018X | 26030451A | IN | Yes |
Addresses
Primary practice location
100 Forest Park PLZ
Brazil, IN 47834-2737
Mailing address
1178 W County Road 800 N
Brazil, IN 47834-7415
Other providers in Brazil, IN
- Melissa Ann Barker
- Melissa D Bass
- Cole Joseph Bennett-Worley
- Ricky Bhimani
- Nilah Nicole Bonham
- Brazil Dental Center, LLC
- Brazil Family Dentistry, LLC
- Brazil Physical Therapy, LLC
- David Allen Breitweiser
- Bright Soul Wellness Center Inc
All providers in Brazil, IN · Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist in Indiana
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 18, 2023. 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.