Bradford Gardens

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

License

RC1217 Issued in SC

Legal business name

BRADFORD GARDENS

Practice address

1108 N Main St
Marion, SC 29571-2029

Phone

(843) 275-0083

NPI assigned

Sep 27, 2007

Last updated

Sep 27, 2007By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. Richard C Cooke

Title

President

Phone

(843) 759-0025

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1190851200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1190851200000",
    "number": "1750578365",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1108 N MAIN ST",
            "city": "MARION",
            "state": "SC",
            "postal_code": "295712029"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1108 N MAIN ST",
            "city": "MARION",
            "state": "SC",
            "postal_code": "295712029",
            "telephone_number": "843-275-0083"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BRADFORD GARDENS",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-09-27",
        "last_updated": "2007-09-27",
        "status": "A",
        "authorized_official_last_name": "COOKE",
        "authorized_official_first_name": "RICHARD",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "843-759-0025",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "SC",
            "license": "RC1217",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "RC1217",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Karen Lynn Berrios, D.M.D.
• Jeffrey Bethea
• Joe Bethea Jr.
• Bio-Medical Applications of South Carolina, Inc. (Fresenius Medical Care Marion)
• Andy Bostick
• Andora Braswell
• Bridgers Drug Store & Gifts LLC (Bridgers Drug Store)
• Zakia Brisbon, PHARM.D
• Jennifer Brown, LPC
• Burgess Primary Family Practice LLC

• Assisted Living Facility in Marion, SC
• Providers in Marion, SC by specialty
• Assisted Living Facility in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 27, 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.