Individual provider · NPI-1

Roger Barry Bradley, RPh

Pharmacist · West Columbia, SC

NPI number1730434572
StatusActive
Last updated in NPPESDec 10, 2012

Details

NPI
1730434572
Entity type
Individual (NPI-1)
Name
Roger Barry Bradley
Credential
RPh
Sex
Male
Sole proprietor
No
Enumeration date
Jul 18, 2012
Last updated
Dec 10, 2012

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
183500000X Pharmacist13701SCYes

Practice location

1537 Charleston Hwy
West Columbia, SC 29169-5047

Phone 803-796-3392

Mailing address

6510 Dare Cir
Columbia, SC 29206-1153

Phone 803-240-8891

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