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A site other than a pharmacy that dispenses medicinal preparations under the supervision of a physician to patients for self-administration. (e.g. physician offices, ER, Urgent Care Centers, Rural Health Facilities, etc.)
Specialty |
Taxonomy Code | Specialty Code | Provider Type | |
Non-Pharmacy Dispensing Site |
332900000X | 87 | All Other Suppliers |
| NPI # | 1255752044 |
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| LBN Legal business name | BRIDGEWATER MEDICAL GROUP PA | ||||
| Authorized official | KENNY HEINE - (VP OF OPERATIONS) | ||||
| Entity | Organization | ||||
| Organization subpart 1 | Yes | ||||
| Enumeration date | 12/20/2013 | ||||
| Last updated | 12/20/2013 - About 12 years ago | ||||
| Identifiers |
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BRIDGEWATER MEDICAL GROUP PA
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BRIDGEWATER MEDICAL GROUP PA