Organization
BRADFORD PHARMACY LLC
Active
Other names
Bradford Family Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
JUSTIN BRADFORD PHARMD (OWNER)
(901) 355-5733
Entity
Organization
Contact information
Practice address
1500 HIGHWAY 51 S, COVINGTON, TN 38019-3212
(901) 475-6300
(901) 475-1888
Mailing address
1500 HIGHWAY 51 S, COVINGTON, TN 38019-3212
(901) 475-6300
(901) 475-1888
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
5145
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2138848
PK
—
Enumeration date
12/19/2012
Last updated
05/04/2016
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