Organization
JAMES R BRADFORD
Active
Other names
BRADFORDS PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
JAMES BRADFRORD (OWNER)
(931) 649-5050
Entity
Organization
Contact information
Practice address
104 HUDGINS ST, ESTILL SPRINGS, TN 37330-3027
(931) 649-5050
(931) 649-3148
Mailing address
104 HUDGINS ST, ESTILL SPRINGS, TN 37330-3027
(931) 649-5050
(931) 649-3148
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
TN3094
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1452215
—
TN
01
—
4430029
NCPDP PROVIDER IDENTIFICATION NUMBER
—
Enumeration date
06/13/2005
Last updated
02/09/2012
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