Organization
BRADBERRY MEDICAL LLC.
Active
Organization
BRADBERRY MEDICAL LLC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JERRY CARL JR. (CEO/PRESIDENT)
(251) 633-8090
Entity
Organization
Contact information
Practice address
839 AIRPORT DRIVE, SUITE 102, ALEXANDER CITY, AL 35010
(256) 215-8654
(256) 215-8655
Mailing address
7856 WESTSIDE PARK DR, SUITE C, MOBILE, AL 36695-8541
(251) 633-8090
(251) 633-6941
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
009932861
—
AL
01
—
51526590
BLUE CROSS BLUE SHIELD
AL
Enumeration date
05/03/2006
Last updated
05/06/2010
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