Provider Demographics
NPI:1053996520
Name:BRADY, PATRICK D
Entity type:Individual
Prefix:
First Name:PATRICK
Middle Name:D
Last Name:BRADY
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5940 TRSSVL XINGS BLVD
Mailing Address - Street 2:
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35235-8607
Mailing Address - Country:US
Mailing Address - Phone:205-655-7324
Mailing Address - Fax:
Practice Address - Street 1:5940 TRSSVL XINGS BLVD
Practice Address - Street 2:
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35235-8607
Practice Address - Country:US
Practice Address - Phone:205-655-7324
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-03-16
Last Update Date:2021-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL21724183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist