NPI 1013639921

Bradley John Parks, PHARMD

Practitioner Pharmacist O Fallon, MO

Practice location

Address: 3029 Highway K, O Fallon, MO 63368-8696
Phone: (636) 240-7749
Fax: (636) 240-7904
Mailing address: 242 Cedar Trail Dr, Ballwin, MO 63011-2655

Registered specialties

Pharmacist Primary

Pharmacy Service Providers Taxonomy 183500000X Licence 2021000059 (MO)

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Registry record

NPI: 1013639921
Entity type: Individual
Sex (as registered): Male
NPI issued: 16 Sep 2022
Record last updated: 16 Sep 2022

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.