James Michael Bragg, RPH
Individual provider Active NPI Pharmacist · Louisville, KY
NPI 1669767604 · NPPES record last updated Jun 17, 2011
Key facts
- NPI
- 1669767604
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pharmacist 183500000X
- License
- 010230 (KY)
- Practice address
- 4640 Taylorsville Rd
Louisville, KY 40220-3530 - Phone
- (502) 493-2732
- NPI assigned
- Jun 17, 2011
- Sex
- Male
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- Credentials
- Registered Pharmacist
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 010230 | KY | MD | Pharmacist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 010230 | KY | Yes |
Addresses
Primary practice location
4640 Taylorsville Rd
Louisville, KY 40220-3530
Mailing address
14610 Inspiration CT
Louisville, KY 40245-3951
Phone (502) 290-0293
Other providers in Louisville, KY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 17, 2011. 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.