Alvin Bradley, RPH PHARMACIST
Individual provider Active NPI Pharmacist · Waverly, VA
NPI 1972607356 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1972607356
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pharmacist 183500000X
- License
- 0202003780 (VA)
- Practice address
- 328 W Main St
Waverly, VA 23890 - Phone
- (804) 834-2233
- NPI assigned
- Sep 7, 2006
- Sex
- Male
- Sole proprietor
- No
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 |
|---|---|---|---|
| 0202003780 | VA | MD | Pharmacist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 0202003780 | VA | Yes |
Addresses
Primary practice location
328 W Main St
Waverly, VA 23890
Mailing address
PO Box 596
Waverly, VA 23890-0596
Other providers in Waverly, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. 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.