Provider Demographics
NPI:1407455728
Name:STRICKLAND, BRADLEY DEWAYNE (PHARMD)
Entity Type:Individual
Prefix:
First Name:BRADLEY
Middle Name:DEWAYNE
Last Name:STRICKLAND
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 1:3124 WILLOUGHBY RD
Mailing Address - Street 2:
Mailing Address - City:TABOR CITY
Mailing Address - State:NC
Mailing Address - Zip Code:28463-8675
Mailing Address - Country:US
Mailing Address - Phone:910-640-7489
Mailing Address - Fax:
Practice Address - Street 1:3040 EVANS ST
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:NC
Practice Address - Zip Code:27834-3176
Practice Address - Country:US
Practice Address - Phone:252-355-6450
Practice Address - Fax:252-378-3751
Is Sole Proprietor?:No
Enumeration Date:2020-10-19
Last Update Date:2020-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC28322183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist