Provider Demographics
NPI:1184946683
Name:BRADSHAW, LINDA (RPH)
Entity type:Individual
Prefix:MS
First Name:LINDA
Middle Name:
Last Name:BRADSHAW
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:525 KNOTTER DR
Mailing Address - Street 2:OMNICARE
Mailing Address - City:CHESHIRE
Mailing Address - State:CT
Mailing Address - Zip Code:06410-1100
Mailing Address - Country:US
Mailing Address - Phone:800-895-8427
Mailing Address - Fax:877-312-3416
Practice Address - Street 1:525 KNOTTER DR
Practice Address - Street 2:OMNICARE
Practice Address - City:CHESHIRE
Practice Address - State:CT
Practice Address - Zip Code:06410-1100
Practice Address - Country:US
Practice Address - Phone:800-895-8427
Practice Address - Fax:877-312-3416
Is Sole Proprietor?:No
Enumeration Date:2010-02-24
Last Update Date:2010-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CTPCT00109041835G0303X
FLPS311961835G0303X
IN130711835G0303X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835G0303XPharmacy Service ProvidersPharmacistGeriatric