Active NPI
Charles Bradley Mills, R.PH.
- Pharmacist
- Elizabethtown, KY
National Provider Identifier
1699834994
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 011417
- Practice address
- 2415 Ring Road
Elizabethtown, KY 42701 - Phone
- (270) 765-2157
- NPI assigned
- Dec 6, 2006
- Sex
- Male
- 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 | 011417 | KY | Primary |
Addresses
Primary practice location
2415 Ring Road
Elizabethtown, KY 42701
Mailing address
158 Mayapple LN
Elizabethtown, KY 42701-8922
Phone (270) 765-3335
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
- Registered Pharmacist
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 011417 | KY | MD | Pharmacist |
Practice roles
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 and National Provider Directory roles.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1165363200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1699834994",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "158 MAYAPPLE LN",
"city": "ELIZABETHTOWN",
"state": "KY",
"postal_code": "427018922",
"telephone_number": "270-765-3335"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2415 RING ROAD",
"city": "ELIZABETHTOWN",
"state": "KY",
"postal_code": "42701",
"telephone_number": "270-765-2157"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MILLS",
"first_name": "CHARLES",
"middle_name": "BRADLEY",
"name_prefix": "Mr.",
"credential": "R.PH.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-12-06",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "KY",
"license": "011417",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Elizabethtown, KY
- Cherryl Miller, LCSW
- Kacey M Miller, B.S., BCABA, LABA
- Lindsay Cherith Miller
- William Luke Milliner, CSW
- Stacy Mills-Blair
- Laura Beth Mills, APRN
- Mind Body & Soul Behavioral Health & Wellness Center
- Mind Body & Soul Life Coach Case Management & Behavioral Health Services
- Holly Minor, B.S.
- Andrew Dane Russell Mitchell, APRN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.