Broad Street Health Inc

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

Legal business name

BROAD STREET HEALTH INC

Doing business as

Ladas Pharmacy

Practice address

1050 S Broad St
Mobile, AL 36603-1038

Phone

(251) 432-5601

NPI assigned

Dec 5, 2023

Organization subpart

No

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

Authorized official

Name

Sterling Rivers

Title

Owner/Pharmacist

Phone

(251) 432-5601

Specialties & licenses 1

Addresses

Other names 1

• Ladas Pharmacy Doing business as

Medicare fee-for-service enrollment

Enrolled in AL

Enrollment records 1

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

{
    "created_epoch": "1701734400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1708560000000",
    "number": "1619744174",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1050 S BROAD ST",
            "city": "MOBILE",
            "state": "AL",
            "postal_code": "366031038",
            "telephone_number": "251-554-7657"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1050 S BROAD ST",
            "city": "MOBILE",
            "state": "AL",
            "postal_code": "366031038",
            "telephone_number": "251-432-5601"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BROAD STREET HEALTH INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-12-05",
        "last_updated": "2024-02-22",
        "certification_date": "2024-02-22",
        "status": "A",
        "authorized_official_last_name": "RIVERS",
        "authorized_official_first_name": "STERLING",
        "authorized_official_title_or_position": "OWNER/PHARMACIST",
        "authorized_official_telephone_number": "251-432-5601"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Ladas Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Brighter Days Counseling Services, LLC
• Thomas Witter Brim, DO
• Ryan Sean Briones, MD
• Shelby Bristow, LPC
• Amy Lynn Britton, CRNP
• Courtney Kuehn Broadfoot, CCC-SLP
• William Eric Broadfoot, MD
• Justin Broadhead, DO
• Alexandra J Brock
• Benjamin Brock, PA

• Community/Retail Pharmacy in Mobile, AL
• Providers in Mobile, AL by specialty
• Community/Retail Pharmacy in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 22, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.