Organization
BRADSHAW HOME MEDICAL EQUIPMENT LLC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. ROBERT KELLER (OWNER/PRESIDENT)
(928) 775-8282
Entity
Organization
Contact information
Practice address
9350 E VALLEY RD, STE C., PRESCOTT VALLEY, AZ 86314-2328
(928) 775-8282
(928) 775-8869
Mailing address
9350 E VALLEY RD, STE C., PRESCOTT VALLEY, AZ 86314-2328
(928) 775-8282
(928) 775-8869
Taxonomy
Speciality
Code
Description
License number
State
332BX2000X
Oxygen Equipment & Supplies (DME)
Primary
20102224
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
022261
—
AZ
Enumeration date
04/21/2006
Last updated
01/21/2015
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