Bradberry Medical LLC.

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

Legal business name

BRADBERRY MEDICAL LLC.

Practice address

839 Airport Drive
Suite 102
Alexander City, AL 35010

Phone

(256) 215-8654

Fax

(256) 215-8655

NPI assigned

May 3, 2006

Organization subpart

No

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

Authorized official

Name

Jerry Carl Jr.

Title

Ceo/President

Phone

(251) 633-8090

Specialties & licenses 1

Addresses

Other identifiers 2

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

{
    "created_epoch": "1146614400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1273104000000",
    "number": "1992763486",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7856 WESTSIDE PARK DR",
            "address_2": "SUITE C",
            "city": "MOBILE",
            "state": "AL",
            "postal_code": "366958541",
            "telephone_number": "251-633-8090",
            "fax_number": "251-633-6941"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "839 AIRPORT DRIVE",
            "address_2": "SUITE 102",
            "city": "ALEXANDER CITY",
            "state": "AL",
            "postal_code": "35010",
            "telephone_number": "256-215-8654",
            "fax_number": "256-215-8655"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BRADBERRY MEDICAL LLC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-03",
        "last_updated": "2010-05-06",
        "status": "A",
        "authorized_official_last_name": "CARL",
        "authorized_official_first_name": "JERRY",
        "authorized_official_title_or_position": "CEO/PRESIDENT",
        "authorized_official_telephone_number": "251-633-8090",
        "authorized_official_name_suffix": "Jr."
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "009932861",
            "state": "AL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "51526590",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• All providers in Alexander City, AL
• Durable Medical Equipment & Medical Supplies in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 6, 2010; 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.