Provider Demographics
NPI:1073804035
Name:BRAGG, ROBERT MEADERS (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:MEADERS
Last Name:BRAGG
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2300 MCFARLAND BLVD
Mailing Address - Street 2:
Mailing Address - City:NORTHPORT
Mailing Address - State:AL
Mailing Address - Zip Code:35476
Mailing Address - Country:US
Mailing Address - Phone:205-339-2700
Mailing Address - Fax:
Practice Address - Street 1:2300 MCFARLAND BLVD
Practice Address - Street 2:
Practice Address - City:NORTHPORT
Practice Address - State:AL
Practice Address - Zip Code:35476-2927
Practice Address - Country:US
Practice Address - Phone:205-339-2700
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-04-26
Last Update Date:2011-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL16471183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist