BRIDGEPORT PHARMACY INC NPI 1356308480

NPI Information

NPI: 1356308480
Provider Name: BRIDGEPORT PHARMACY, INC

Doing Business As: BRIDGEPORT HOME MEDICAL SUPPLY

Classification: Durable Medical Equipment & Medical Supplies - 332BC3200X
Entity Type: Organization

Specialization: Customized Equipment

Address:
6226 DIXIE HWY
BRIDGEPORT, MI
ZIP 48722
Phone: (989) 777-3286
Get Directions

BRIDGEPORT PHARMACY, INC is a customized equipment durable medical equipment medical supplies in Bridgeport, MI. BRIDGEPORT PHARMACY, INC NPI is 1356308480. The provider is registered as an organization entity type.
The provider Is Doing Business As Bridgeport Home Medical Supply.

The provider's business location address is:

6226 DIXIE HWY
BRIDGEPORT, MI
ZIP 48722-513
Phone: (989) 777-3286
Fax: (989) 777-3384

The provider's authorized official is Karen Marie Boettcher .
The authorized official title is Vice President and has the following contact phone number (989) 777-3286.

The enumeration date for this NPI number is 5/1/2006 and was last updated on 12/10/2010.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	332BC3200X	Durable Medical Equipment & Medical Supplies	Customized Equipment	10657A	MICHIGAN	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	1300560001	MEDICARE NSC	MICHIGAN
2	4226131	MEDICAID	MICHIGAN
3	0G30386	OTHER	MICHIGAN	BLUE CROSS BLUE SHIELD

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

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