Bradley John Eide, R.PH.

Primary specialty

PharmacistTaxonomy code 183500000X

License

116710 Issued in MN

Practice address

1475 W Service Dr
Winona, MN 55987-2512

Phone

(507) 452-5254

NPI assigned

Mar 28, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 4

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Registered Pharmacist

State licenses

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

{
    "created_epoch": "1175040000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1730208372",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "525 E LARKSPUR LN",
            "city": "ONALASKA",
            "state": "WI",
            "postal_code": "546508304",
            "telephone_number": "608-779-5550"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1475 W SERVICE DR",
            "city": "WINONA",
            "state": "MN",
            "postal_code": "559872512",
            "telephone_number": "507-452-5254"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EIDE",
        "first_name": "BRADLEY",
        "middle_name": "JOHN",
        "name_prefix": "Mr.",
        "credential": "R.PH.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-28",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "MN",
            "license": "116710",
            "primary": true
        },
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "VA",
            "license": "0202009270",
            "primary": false
        },
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "WI",
            "license": "13071-040",
            "primary": false
        },
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "ND",
            "license": "4002",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Gracie Lynn Egger
• Michelle Ehlenfeldt, OTA
• Jennifer B Eichman, D.C.
• Jude B Eichman, D.C.
• Laura Eichmann
• Mario Walter Einsman, M.S.
• Lisa Michelle Ellenburg, LICSW
• Linda Lou Ellinghuysen, R.N.
• Emily Elmquist, MSW CLINICAL INTERN
• Payton Engbrecht

• Pharmacist in Winona, MN
• Providers in Winona, MN by specialty
• Pharmacist in Minnesota

• 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.

Verify at the official NPI Registry.