Provider Demographics
NPI:1295758688
Name:BRADEN PARTNERS LP
Entity type:Organization
Organization Name:BRADEN PARTNERS LP
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CHIEF COMPLIANCE OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:WENDY
Authorized Official - Middle Name:
Authorized Official - Last Name:RUSSALESI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:484-246-9499
Mailing Address - Street 1:555 E NORTH LN STE 5075
Mailing Address - Street 2:
Mailing Address - City:CONSHOHOCKEN
Mailing Address - State:PA
Mailing Address - Zip Code:19428-2233
Mailing Address - Country:US
Mailing Address - Phone:661-665-6040
Mailing Address - Fax:
Practice Address - Street 1:4562 WESTINGHOUSE ST STE F
Practice Address - Street 2:
Practice Address - City:VENTURA
Practice Address - State:CA
Practice Address - Zip Code:93003-5797
Practice Address - Country:US
Practice Address - Phone:747-224-8338
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-26
Last Update Date:2025-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies
No3336M0002XSuppliersPharmacyMail Order Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
ID807416100Medicaid
WY122587100Medicaid
NM12881228Medicaid
KS200363380BMedicaid
CAPHA455660Medicaid
OR210515Medicaid
WA9058660Medicaid
OK200073720CMedicaid
AZ066344Medicaid
WA6023428Medicaid
WA9062142Medicaid
IN200835660BMedicaid
AZ410856Medicaid
WA6031686Medicaid
OR240373Medicaid
IN200835660BMedicaid
IL=========010Medicaid
CAPHA455660Medicaid
CAPHA455660Medicaid
IL=========010Medicaid