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Contact Information

BRIDGEPORT PHARMACY INC
200 ROUTE 98 W ST
STE 105A
NUTTER FORT, WV26301-4385
 Phone: 304-624-0974
 Fax: 304-624-0979
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Community/Retail Pharmacy

3336C0003X 58 Medical Supply Company with Pharmacist
Indicates primary specialty

NPI Profile & details for BRIDGEPORT PHARMACY INC

NPI # 1063667947
LBN Legal business name BRIDGEPORT PHARMACY INC
Authorized official SAAD MOSSALLATI - (TREASURER)
Entity Organization
Organization subpart 1 No
Enumeration date 11/19/2008
Last updated 03/17/2014 - About 12 years ago
Identifiers
WV License # SP0552382
Other 2118653 PK
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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