Provider Demographics
NPI:1851678569
Name:LAFLEN, BRAD (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:BRAD
Middle Name:
Last Name:LAFLEN
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 1:11550 PAGE SERVICE DR STE 101
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63146-3552
Mailing Address - Country:US
Mailing Address - Phone:314-344-9201
Mailing Address - Fax:
Practice Address - Street 1:11550 PAGE SERVICE DR STE 101
Practice Address - Street 2:
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63146-3552
Practice Address - Country:US
Practice Address - Phone:314-344-9201
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-11-08
Last Update Date:2015-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2011026587183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist