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Individual

BRADLEY S DEEGAN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
PHARMD

Contact information

Practice address
311 STRAIGHT ST, CINCINNATI, OH 45219-1018
(513) 559-2346
(513) 475-5269
Mailing address
3392 WOODLYN HILLS DR, ERLANGER, KY 41018-2600
(859) 426-7764
(513) 475-5269

Taxonomy

Speciality
Code
Description
License number
State
183500000X
Pharmacist
012193
KY
183500000X
Pharmacist
Primary
03-1-24778
OH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
012193
KY PHARMACIST LICENSE #
KY
01
03-1-24778
OHIO PHARMACIST LICENSE #
OH
Enumeration date
01/15/2007
Last updated
07/08/2007
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