Organization
BRADLEY FREE CLINIC OF ROANOKE VALLEY
Active
Other names
BRADLEY FREE CLINIC
Organization subpart
No
Provider details
NPI number
Authorized official
JAMES BLACK (PHARMACIST IN CHARGE)
(540) 344-5156
Entity
Organization
Contact information
Practice address
1240 3RD ST SW, ROANOKE, VA 24016-4612
(540) 344-5156
(540) 777-0726
Mailing address
1240 3RD ST SW, ROANOKE, VA 24016-4612
(540) 344-5156
(540) 777-0726
Taxonomy
Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
Primary
—
—
333600000X
Pharmacy
0201002648
VA
3336C0003X
Community/Retail Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2164384
PK
—
Enumeration date
09/20/2012
Last updated
02/03/2021
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