Provider Demographics
NPI:1427081876
Name:BRADEN PARTNERS LP
Entity type:Organization
Organization Name:BRADEN PARTNERS LP
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CHIEF EXECUTIVE OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:JANE
Authorized Official - Middle Name:L
Authorized Official - Last Name:THOMAS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:415-893-1518
Mailing Address - Street 1:8730 HARRIS RD.
Mailing Address - Street 2:UNIT 204
Mailing Address - City:BAKERSFIELD
Mailing Address - State:CA
Mailing Address - Zip Code:93311-8990
Mailing Address - Country:US
Mailing Address - Phone:661-396-3720
Mailing Address - Fax:661-832-6009
Practice Address - Street 1:7850 S HARDY DR
Practice Address - Street 2:SUITE 105
Practice Address - City:TEMPE
Practice Address - State:AZ
Practice Address - Zip Code:85284-1122
Practice Address - Country:US
Practice Address - Phone:480-477-3085
Practice Address - Fax:480-477-3089
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-09
Last Update Date:2013-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336M0002XSuppliersPharmacyMail Order Pharmacy
No332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ991655Medicaid
KS200363380CMedicaid
ID807577400Medicaid
MN933457000Medicaid
NM03525376Medicaid
OR247370Medicaid
NV100510346Medicaid
PA102200433-0003Medicaid
UT1427081876Medicaid
CAXPH015089Medicaid
OK200073720EMedicaid
IN200835660AMedicaid
AZ410773Medicaid
WA6029029Medicaid
OK200073720DMedicaid
NV100510346Medicaid
ID807577400Medicaid
0393850123Medicare NSC