Provider Demographics
NPI:1992490643
Name:CARPER, BRAD (PHARMD)
Entity type:Individual
Prefix:DR
First Name:BRAD
Middle Name:
Last Name:CARPER
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 1:501 RIVER BEND WAY
Mailing Address - Street 2:
Mailing Address - City:GRAYSON
Mailing Address - State:KY
Mailing Address - Zip Code:41143-1730
Mailing Address - Country:US
Mailing Address - Phone:606-232-1528
Mailing Address - Fax:606-232-1528
Practice Address - Street 1:501 RIVER BEND WAY
Practice Address - Street 2:
Practice Address - City:GRAYSON
Practice Address - State:KY
Practice Address - Zip Code:41143-1730
Practice Address - Country:US
Practice Address - Phone:606-232-1528
Practice Address - Fax:606-232-1528
Is Sole Proprietor?:Yes
Enumeration Date:2023-04-10
Last Update Date:2023-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY017078183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist