Provider Demographics
NPI:1033285176
Name:BRADY'S PHARMACY
Entity Type:Organization
Organization Name:BRADY'S PHARMACY
Other - Org Name:HOME MED CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:DEBORAH
Authorized Official - Middle Name:
Authorized Official - Last Name:BRADY
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:708-598-2882
Mailing Address - Street 1:8722 S 88TH AVE
Mailing Address - Street 2:
Mailing Address - City:HICKORY HILLS
Mailing Address - State:IL
Mailing Address - Zip Code:60457-1201
Mailing Address - Country:US
Mailing Address - Phone:708-598-2882
Mailing Address - Fax:
Practice Address - Street 1:3237 W 111TH ST
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60655-2730
Practice Address - Country:US
Practice Address - Phone:773-238-6686
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-28
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL332BP3500X, 332BX2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered332BP3500XSuppliersDurable Medical Equipment & Medical SuppliesParenteral & Enteral Nutrition
Not Answered332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL1670765OtherBLUE CROSS BLUE SHIELD
IL=========005Medicaid
IL03454600001Medicare ID - Type Unspecified