Provider Demographics
NPI:1871517409
Name:BRADEN PARTNERS LP
Entity type:Organization
Organization Name:BRADEN PARTNERS LP
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:SVP CUSTOMER CARE
Authorized Official - Prefix:
Authorized Official - First Name:YVONNE
Authorized Official - Middle Name:M
Authorized Official - Last Name:CORDOZA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:415-893-1518
Mailing Address - Street 1:4300 STINE RD
Mailing Address - Street 2:STE 800
Mailing Address - City:BAKERSFIELD
Mailing Address - State:CA
Mailing Address - Zip Code:93313-2354
Mailing Address - Country:US
Mailing Address - Phone:661-396-3720
Mailing Address - Fax:661-832-6010
Practice Address - Street 1:509 ARMSTRONG WAY
Practice Address - Street 2:SUITE C
Practice Address - City:OAKDALE
Practice Address - State:CA
Practice Address - Zip Code:95361-7775
Practice Address - Country:US
Practice Address - Phone:209-848-1014
Practice Address - Fax:209-848-9177
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-27
Last Update Date:2008-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
CADME03203FMedicaid
0393850090Medicare NSC